非结构性冠状动脉疾病和多血管疾病患者。KAMMA (俄罗斯联邦和欧亚国家多血管疾病患者临床登记处)真实世界登记处子分析。

IF 0.5 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Kardiologiya Pub Date : 2024-08-31 DOI:10.18087/cardio.2024.8.n2683
G P Arutyunov, E I Tarlovskaya, A G Arutyunov, T I Batluk, N A Koziolova, A I Chesnikova, A Yu Vaskin, D S Tokmin, I G Bakulin, O L Barbarash, N Yu Grigoryeva, I V Gubareva, N V Izmozherova, U K Kamilova, S G Kechedzhieva, Z F Kim, N A Koriagina, S V Mironova, N P Mitkovskaya, S V Nemirova, L M Nurieva, M M Petrova, E A Polyanskaya, A P Rebrov, A V Svarovskaya, E A Smirnova, A B Sugraliev, Ya B Khovaeva, G V Shavkuta, I I Shaposhnik, M Yu K Alieva, A B Almukhanova, A V Aparkina, R A Bashkinov, L N Belousova, E I Blokhina, V O Bochkareva, V M Buianova, F Yu Valikulova, A D Vende, A S Galyavich, V V Genkel, E V Gorbunova, E D Gordeychuk, E A Grigorenko, E V Grigoryeva, I L Davydkin, D S Evdokimov, A N Ermilova, Sh B Zhangelova, N V Zhdankina, E I Zheleznyak, N S Ilyanok, D A Kapsultanova, N A Karoli, E A Kartashova, A S Kuznetsova, A T Kumaritova, N A Magdeeva, S A Makarov, E S Melnikov, M V Novikova, I A Obukhova, E V Ponomarenko, A O Rubanenko, O A Rubanenko, F E Rustamova, V A Safronenko, E I Suchkova, A I Sycheva, D R Tagaeva, M A Trubnikova, T P Trunina, A G Frolov, V V Khatlamadzhiyan, Yu I Khokhlova, A I Chernyavina, O Yu Chizhova, M A O Shambatov, T V Shnyukova, Yu V Shchukin
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引用次数: 0

摘要

目的:研究KAMMA登记中的非梗阻性缺血性心脏病(IHD)和多灶性动脉粥样硬化(MFA)患者的临床状况以及实验室和仪器检查数据:子分析包括 1,893 名接受冠状动脉造影术 (CAG) 和外周动脉超声波检查的 IHD 患者。根据冠状动脉造影数据,患者被分为两组:第一组,阻塞性冠状动脉粥样硬化(CA)患者(最大狭窄≥50%和/或有经皮冠状动脉介入治疗/冠状动脉旁路移植史,n=1728;91.3%);第二组,非阻塞性CA患者(最大狭窄<50%,n=165;8.7%):根据 KAMMA 登记中已确诊的 IHD 患者的冠状动脉阻塞程度进行的比较分析表明,8.7% 的患者冠状动脉狭窄程度小于 50%。绝大多数非阻塞性 CA 患者的肱动脉受 MFA 影响的比例为 94.3%,下肢动脉受影响的比例为 40.2%。在非阻塞性 IHD 患者中,女性居多;与阻塞性 IHD 组相比,该组患者中吸烟和 2 型糖尿病等风险因素的发生率较低。与阻塞性心肌梗死患者相比,非阻塞性心肌梗死患者更常见血脂异常病史;总胆固醇和非高密度脂蛋白胆固醇更高;更常接受中等强度的他汀类药物治疗(55.8% 对 34.5%)。非阻塞性 CA 患者的特征是不太严重的 IHD 和较少的急性冠状动脉综合征病史。然而,中风、外周动脉血栓和下肢慢性动脉功能不全的发生率在第一组和第二组中没有差异,而阵发性心房颤动的发生率在非阻塞性 IHD 组中较高:结论:无冠状动脉阻塞的 IHD 患者也需要评估外周动脉状况,因为他们可能患有晚期 MFA,在选择治疗的 "积极性 "时应考虑到这一点。
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Patients With Non-Obstructive Coronary Artery Disease and Polyvascular Disease. Sub-Analysis of the Real-World Registry KAMMA (Clinical Registry on Patient Population With Polyvascular Disease in the Russian Federation and Eurasian Countries).

Aim: To study the clinical status and data of laboratory and instrumental examination of patients with non-obstructive ischemic heart disease (IHD) and multifocal atherosclerosis (MFA) included in the KAMMA registry.

Material and methods: The subanalysis included 1,893 IHD patients who underwent coronary angiography (CAG) and ultrasonic examination of peripheral arteries. Based on the CAG data, patients were divided into two groups: group 1, patients with obstructive coronary atherosclerosis (CA) (maximum stenosis ≥50% and/or history of percutaneous coronary intervention/coronary artery bypass grafting, n=1728; 91.3%) and group 2, patients with non-obstructive CA (maximum stenosis <50%, n = 165; 8.7%).

Results: A comparative analysis based on the degree of coronary obstruction in patients with verified IHD who were included in the KAMMA registry showed that 8.7% of them had coronary artery stenosis of less than 50%. The overwhelming majority of patients with non-obstructive CA had MFA affecting the brachiocephalic arteries in 94.3% and the lower extremity arteries in 40.2%. Among patients with non-obstructive IHD, women predominated; risk factors such as smoking and type 2 diabetes mellitus were less frequent in this group than in the obstructive IHD group. Patients with non-obstructive CA more frequently had a history of dyslipidemia; they had higher total cholesterol and non-high-density lipoprotein cholesterol; and they more frequently received moderate-intensity statin therapy than patients with obstructive CA (55.8% vs. 34.5%). Characteristic features of patients with non-obstructive CA were less severe IHD and less frequent history of acute coronary syndrome. However, the incidence of stroke, peripheral arterial thrombosis, and chronic arterial insufficiency of the lower extremities did not differ in groups 1 and 2, whereas the incidence of paroxysmal atrial fibrillation was higher in the non-obstructive IHD group.

Conclusion: IHD patients without coronary obstruction also require assessment of the peripheral arterial status, as they may have advanced MFA, which should be taken into account when choosing the "aggressiveness" of therapy.

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来源期刊
Kardiologiya
Kardiologiya 医学-心血管系统
CiteScore
1.70
自引率
20.00%
发文量
94
审稿时长
3-8 weeks
期刊介绍: “Kardiologiya” (Cardiology) is a monthly scientific, peer-reviewed journal committed to both basic cardiovascular medicine and practical aspects of cardiology. As the leader in its field, “Kardiologiya” provides original coverage of recent progress in cardiovascular medicine. We publish state-of-the-art articles integrating clinical and research activities in the fields of basic cardiovascular science and clinical cardiology, with a focus on emerging issues in cardiovascular disease. Our target audience spans a diversity of health care professionals and medical researchers working in cardiovascular medicine and related fields. The principal language of the Journal is Russian, an additional language – English (title, authors’ information, abstract, keywords). “Kardiologiya” is a peer-reviewed scientific journal. All articles are reviewed by scientists, who gained high international prestige in cardiovascular science and clinical cardiology. The Journal is currently cited and indexed in major Abstracting & Indexing databases: Web of Science, Medline and Scopus. The Journal''s primary objectives Contribute to raising the professional level of medical researchers, physicians and academic teachers. Present the results of current research and clinical observations, explore the effectiveness of drug and non-drug treatments of heart disease, inform about new diagnostic techniques; discuss current trends and new advancements in clinical cardiology, contribute to continuing medical education, inform readers about results of Russian and international scientific forums; Further improve the general quality of reviewing and editing of manuscripts submitted for publication; Provide the widest possible dissemination of the published articles, among the global scientific community; Extend distribution and indexing of scientific publications in major Abstracting & Indexing databases.
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