风险因素对介入和非介入冠状动脉病变的影响。

IF 1.3 American journal of cardiovascular disease Pub Date : 2024-08-25 eCollection Date: 2024-01-01 DOI:10.62347/XTBG3549
Xincheng Sheng, Gan Yang, Qing Zhang, Yong Zhou, Jun Pu
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引用次数: 0

摘要

导言:支架内再狭窄(ISR)和非介入冠状动脉病变加重(ANL)是冠状动脉疾病(CAD)患者疾病进展的两个关键方面。这两种疾病的既定风险因素包括高脂血症、高血压、糖尿病、慢性肾病和吸烟。然而,关于这两方面疾病进展风险因素的比较研究却很有限。本研究旨在分析和比较相同风险因素对 ISR 和 ANL 的不同影响:本研究共纳入了 510 名接受重复冠状动脉造影术(CAG)的多发性冠状动脉病变患者。所有患者之前都接受过经皮冠状动脉介入治疗(PCI),除了之前介入的血管外,还存在未介入的冠状动脉病变:经过数据分析,确定 HbA1c(OR 1.229,95% CI 1.022-1.477,P=0.028)和 UA(OR 1.003,95% CI 1.000-1.005,P=0.024)为 ISR 的独立危险因素。此外,HbA1c(OR 1.215,95% CI 1.010-1.460,P=0.039)、Scr(OR 1.007,95% CI 1.003-1.017,P=0.009)和载脂蛋白B(OR 1.017,95% CI 1.006-1.029,P=0.004)被确定为ANL的独立危险因素。多种血脂水平的分布在仅有 ANL 组和仅有 ISR 组之间存在差异。仅有ANL组与仅有ISR组相比,非HDL-C(2.17 mmol/L vs. 2.44 mmol/L,P=0.007)和载脂蛋白B(63.5 mg/dL vs. 71.0 mg/dL,P=0.011)的值明显更高:结论:血糖水平和慢性肾脏疾病被确定为 ISR 和 ANL 的独立风险因素,而血脂水平升高仅与 ANL 有明显相关性。对于PCI术后出现非介入冠状动脉病变的患者,评估非高密度脂蛋白胆固醇(Non-HDL-C)和载脂蛋白B的浓度至关重要,因为它们是重要的风险因素。
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Impact of risk factors on intervened and non-intervened coronary lesions.

Introduction: In-stent restenosis (ISR) and aggravated non-intervened coronary lesions (ANL) are two pivotal aspects of disease progression in patients with coronary artery disease (CAD). Established risk factors for both include hyperlipidemia, hypertension, diabetes, chronic kidney disease, and smoking. However, there is limited research on the comparative risk factors for the progression of these two aspects of progression. The aim of this study was to analyze and compare the different impacts of identical risk factors on ISR and ANL.

Methods: This study enrolled a total of 510 patients with multiple coronary artery lesions who underwent repeated coronary angiography (CAG). All patients had previously undergone percutaneous coronary intervention (PCI) and presented non-intervened coronary lesions in addition to the previously intervened vessels.

Results: After data analysis, it was determined that HbA1c (OR 1.229, 95% CI 1.022-1.477, P=0.028) and UA (OR 1.003, 95% CI 1.000-1.005, P=0.024) were identified as independent risk factors for ISR. Furthermore, HbA1c (OR 1.215, 95% CI 1.010-1.460, P=0.039), Scr (OR 1.007, 95% CI 1.003-1.017, P=0.009), and ApoB (OR 1.017, 95% CI 1.006-1.029, P=0.004) were identified as independent risk factors for ANL. The distribution of multiple blood lipid levels differed between the ANL only group and the ISR only group. Non-HDL-C (2.17 mmol/L vs. 2.44 mmol/L, P=0.007) and ApoB (63.5 mg/dL vs. 71.0 mg/dL, P=0.011) exhibited significantly higher values in the ANL only group compared to the ISR only group.

Conclusions: Blood glucose levels and chronic kidney disease were identified as independent risk factors for both ISR and ANL, while elevated lipid levels were only significantly associated with ANL. In patients with non-intervened coronary lesions following PCI, it is crucial to assess the concentration of non-HDL-C and ApoB as they serve as significant risk factors.

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来源期刊
American journal of cardiovascular disease
American journal of cardiovascular disease CARDIAC & CARDIOVASCULAR SYSTEMS-
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