冠脉搭桥术后冠脉血流测量作为移植物失败和主要不良心脏事件的预测因子

Hong Jun Yong, Mei Ann Lim, Kenneth Kok, Nadzir Juanda, Sofian Johar
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摘要

我们的目的是表征失败和正常移植物的过境时间流量测量(TTFM)的差异,并确定TTFM与相关临床因素以及冠状动脉搭桥术后移植物失败和主要不良心脏事件(MACE)的可能性之间的关系。材料和方法对2017年至2019年住院的279例患者进行回顾性观察分析,比较失败和正常移植物之间TTFM的差异,以及TTFM与主要心脏不良事件(MACE) -特别是心绞痛、心肌梗死和死亡之间的关系。结果失败移植物与正常移植物的TTFM无明显差异。心脏搏动指数(PI) >的移植物失败率较高;5与PI≤5比较(χ<sup>2</sup>= 4.021, p = 0.045)。多因素分析显示TTFM与MACE无显著相关性。女性(p = 0.031)、充血性心力衰竭史(p = 0.025)和肾功能不佳(p = 0.034)与移植物衰竭风险增加有关。冠脉介入史(p = 0.041)、左冠状动脉优势(p = 0.018)和肾功能(p = 0.009)与MACE风险增加有关。结论移植物通畅受性别、充血性心力衰竭和肾功能的影响,而MACE受冠状动脉介入史和肾功能的影响。
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Transit time flow measurement as a predictor of graft failure and major adverse cardiac events following coronary artery bypass grafting surgery
Introduction Our aims were to characterize the differences in transit time flow measurement (TTFM) between failed and normal grafts, and to determine the association between TTFM and related clinical factors and the likelihood of graft failure and major adverse cardiac events (MACE) following coronary artery bypass grafting. Material and methods A retrospective observational analysis was performed on 279 patients admitted between 2017 and 2019, to compare the differences in TTFM between failed and normal grafts, and the association between TTFM and major adverse cardiac events (MACE) – specifically angina, myocardial infarction, and death. Results There were no differences in TTFM between failed and normal grafts. There was a greater number of failed grafts with pulsatility index (PI) > 5 compared to PI ≤ 5 (χ2 = 4.021, p = 0.045). Multivariate analysis showed no significant association between TTFM and MACE. Increased risk of graft failure is associated with the female gender (p = 0.031), history of congestive heart failure (p = 0.025), and poor renal function (p = 0.034). Increased risk of MACE is associated with a history of coronary intervention (p = 0.041), left coronary dominance (p = 0.018), and renal function (p = 0.009). Conclusions Patency of graft is influenced by gender, congestive heart failure, and renal function, while MACE is influenced by history of coronary intervention and renal function.
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