Iván Sánchez-Sánchez MD , Enrico Cerrato MD, PhD , Mario Bollati MD , Carolina Espejo-Paeres MD , Luis Nombela-Franco MD, PhD , Emilio Alfonso-Rodríguez MD , Santiago J. Camacho-Freire MD, PhD , Pedro A. Villablanca MD , Ignacio J. Amat-Santos MD, PhD , José M. De la Torre Hernández MD, PhD , Isaac Pascual MD, PhD , Christoph Liebetrau MD, PhD , Benjamín Camacho MD , Marco Pavani MD , Juan Albistur MD , Roberto Adriano Latini MD , Ferdinando Varbella MD , Víctor Alfonso Jiménez Díaz MD , Davide Piraino MD , Massimo Mancone MD, PhD , Iván J. Núñez-Gil MD, PhD
{"title":"冠状动脉瘤的长期预后","authors":"Iván Sánchez-Sánchez MD , Enrico Cerrato MD, PhD , Mario Bollati MD , Carolina Espejo-Paeres MD , Luis Nombela-Franco MD, PhD , Emilio Alfonso-Rodríguez MD , Santiago J. Camacho-Freire MD, PhD , Pedro A. Villablanca MD , Ignacio J. Amat-Santos MD, PhD , José M. De la Torre Hernández MD, PhD , Isaac Pascual MD, PhD , Christoph Liebetrau MD, PhD , Benjamín Camacho MD , Marco Pavani MD , Juan Albistur MD , Roberto Adriano Latini MD , Ferdinando Varbella MD , Víctor Alfonso Jiménez Díaz MD , Davide Piraino MD , Massimo Mancone MD, PhD , Iván J. Núñez-Gil MD, PhD","doi":"10.1016/j.jcin.2024.08.034","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Limited data are available to guide the management of coronary artery aneurysms (CAAs).</div></div><div><h3>Objectives</h3><div>The authors sought to define the clinical characteristics, identify variables that predict outcomes, and provide long-term data on CAAs.</div></div><div><h3>Methods</h3><div>We describe outcomes from 1,729 consecutive patients with CAAs included in an ambispective international registry (CAAR [Coronary Artery Aneurysm Registry]; <span><span>NCT02563626</span><svg><path></path></svg></span>) involving 33 hospitals across 9 countries in America and Europe.</div></div><div><h3>Results</h3><div>Patients were predominantly male (78.6%; 1,359/1,729) with a mean age of 66 years. Classic cardiovascular risk factors were common, as well as coronary artery disease (85.8%; 1,484/1,729), peripheral vascular disease (10.9%; 188/1,729), and chronic kidney disease (8.0%; 138/1,729). The median number of aneurysms per patient was 1.0 (Q1-Q3: 1.0-1.0), with the most affected territory being the left anterior descending artery (49.6%; 857/1,729). The majority underwent any revascularization procedure (68.5%; 1,184/1,729), mainly percutaneous coronary intervention (50.7%; 877/1,729), and were discharged on dual antiplatelet therapy (65.6%; 1,134/1,729). After a median follow-up of 44.8 months (Q1-Q3: 14.9-88.1), 379 died (21.9%), and 641 (37.1%) developed a major adverse cardiovascular event (MACE) (all-cause death, heart failure, unstable angina, and reinfarction). In a multivariable analysis, age (HR: 1.03; 95% CI: 1.02-1.04; <em>P</em> < 0.001), diabetes mellitus (HR: 1.47; 95% CI: 1.23-1.75; <em>P</em> < 0.001), renal insufficiency (HR: 1.53; 95% CI: 1.19-1.96; <em>P</em> = 0.010), peripheral vessel disease (HR: 1.43; 95% CI: 1.13-1.82; <em>P</em> = 0.003), reduced left ventricular ejection fraction (HR: 0.98; 95% CI: 0.98-0.99; <em>P</em> < 0.001), acute indication for the index coronary angiography (HR: 1.30; 95% CI: 1.08-1.55; <em>P</em> = 0.005), and the number of coronary vessels presenting severe stenosis (HR: 1.11; 95% CI: 1.02-1.20; <em>P</em> = 0.015) were independent predictors of MACEs. Remarkably, only 37 patients presented with local aneurysm complications during follow-up.</div></div><div><h3>Conclusions</h3><div>The long-term prognosis of CAAs is not favorable, with MACEs associated with the underlying risk factor profile for atherosclerotic heart disease.</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"17 22","pages":"Pages 2681-2691"},"PeriodicalIF":11.7000,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Long-Term Prognosis of Coronary Aneurysms\",\"authors\":\"Iván Sánchez-Sánchez MD , Enrico Cerrato MD, PhD , Mario Bollati MD , Carolina Espejo-Paeres MD , Luis Nombela-Franco MD, PhD , Emilio Alfonso-Rodríguez MD , Santiago J. Camacho-Freire MD, PhD , Pedro A. Villablanca MD , Ignacio J. Amat-Santos MD, PhD , José M. De la Torre Hernández MD, PhD , Isaac Pascual MD, PhD , Christoph Liebetrau MD, PhD , Benjamín Camacho MD , Marco Pavani MD , Juan Albistur MD , Roberto Adriano Latini MD , Ferdinando Varbella MD , Víctor Alfonso Jiménez Díaz MD , Davide Piraino MD , Massimo Mancone MD, PhD , Iván J. Núñez-Gil MD, PhD\",\"doi\":\"10.1016/j.jcin.2024.08.034\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Limited data are available to guide the management of coronary artery aneurysms (CAAs).</div></div><div><h3>Objectives</h3><div>The authors sought to define the clinical characteristics, identify variables that predict outcomes, and provide long-term data on CAAs.</div></div><div><h3>Methods</h3><div>We describe outcomes from 1,729 consecutive patients with CAAs included in an ambispective international registry (CAAR [Coronary Artery Aneurysm Registry]; <span><span>NCT02563626</span><svg><path></path></svg></span>) involving 33 hospitals across 9 countries in America and Europe.</div></div><div><h3>Results</h3><div>Patients were predominantly male (78.6%; 1,359/1,729) with a mean age of 66 years. Classic cardiovascular risk factors were common, as well as coronary artery disease (85.8%; 1,484/1,729), peripheral vascular disease (10.9%; 188/1,729), and chronic kidney disease (8.0%; 138/1,729). The median number of aneurysms per patient was 1.0 (Q1-Q3: 1.0-1.0), with the most affected territory being the left anterior descending artery (49.6%; 857/1,729). The majority underwent any revascularization procedure (68.5%; 1,184/1,729), mainly percutaneous coronary intervention (50.7%; 877/1,729), and were discharged on dual antiplatelet therapy (65.6%; 1,134/1,729). After a median follow-up of 44.8 months (Q1-Q3: 14.9-88.1), 379 died (21.9%), and 641 (37.1%) developed a major adverse cardiovascular event (MACE) (all-cause death, heart failure, unstable angina, and reinfarction). In a multivariable analysis, age (HR: 1.03; 95% CI: 1.02-1.04; <em>P</em> < 0.001), diabetes mellitus (HR: 1.47; 95% CI: 1.23-1.75; <em>P</em> < 0.001), renal insufficiency (HR: 1.53; 95% CI: 1.19-1.96; <em>P</em> = 0.010), peripheral vessel disease (HR: 1.43; 95% CI: 1.13-1.82; <em>P</em> = 0.003), reduced left ventricular ejection fraction (HR: 0.98; 95% CI: 0.98-0.99; <em>P</em> < 0.001), acute indication for the index coronary angiography (HR: 1.30; 95% CI: 1.08-1.55; <em>P</em> = 0.005), and the number of coronary vessels presenting severe stenosis (HR: 1.11; 95% CI: 1.02-1.20; <em>P</em> = 0.015) were independent predictors of MACEs. Remarkably, only 37 patients presented with local aneurysm complications during follow-up.</div></div><div><h3>Conclusions</h3><div>The long-term prognosis of CAAs is not favorable, with MACEs associated with the underlying risk factor profile for atherosclerotic heart disease.</div></div>\",\"PeriodicalId\":14688,\"journal\":{\"name\":\"JACC. Cardiovascular interventions\",\"volume\":\"17 22\",\"pages\":\"Pages 2681-2691\"},\"PeriodicalIF\":11.7000,\"publicationDate\":\"2024-11-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JACC. Cardiovascular interventions\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1936879824011543\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JACC. Cardiovascular interventions","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1936879824011543","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Limited data are available to guide the management of coronary artery aneurysms (CAAs).
Objectives
The authors sought to define the clinical characteristics, identify variables that predict outcomes, and provide long-term data on CAAs.
Methods
We describe outcomes from 1,729 consecutive patients with CAAs included in an ambispective international registry (CAAR [Coronary Artery Aneurysm Registry]; NCT02563626) involving 33 hospitals across 9 countries in America and Europe.
Results
Patients were predominantly male (78.6%; 1,359/1,729) with a mean age of 66 years. Classic cardiovascular risk factors were common, as well as coronary artery disease (85.8%; 1,484/1,729), peripheral vascular disease (10.9%; 188/1,729), and chronic kidney disease (8.0%; 138/1,729). The median number of aneurysms per patient was 1.0 (Q1-Q3: 1.0-1.0), with the most affected territory being the left anterior descending artery (49.6%; 857/1,729). The majority underwent any revascularization procedure (68.5%; 1,184/1,729), mainly percutaneous coronary intervention (50.7%; 877/1,729), and were discharged on dual antiplatelet therapy (65.6%; 1,134/1,729). After a median follow-up of 44.8 months (Q1-Q3: 14.9-88.1), 379 died (21.9%), and 641 (37.1%) developed a major adverse cardiovascular event (MACE) (all-cause death, heart failure, unstable angina, and reinfarction). In a multivariable analysis, age (HR: 1.03; 95% CI: 1.02-1.04; P < 0.001), diabetes mellitus (HR: 1.47; 95% CI: 1.23-1.75; P < 0.001), renal insufficiency (HR: 1.53; 95% CI: 1.19-1.96; P = 0.010), peripheral vessel disease (HR: 1.43; 95% CI: 1.13-1.82; P = 0.003), reduced left ventricular ejection fraction (HR: 0.98; 95% CI: 0.98-0.99; P < 0.001), acute indication for the index coronary angiography (HR: 1.30; 95% CI: 1.08-1.55; P = 0.005), and the number of coronary vessels presenting severe stenosis (HR: 1.11; 95% CI: 1.02-1.20; P = 0.015) were independent predictors of MACEs. Remarkably, only 37 patients presented with local aneurysm complications during follow-up.
Conclusions
The long-term prognosis of CAAs is not favorable, with MACEs associated with the underlying risk factor profile for atherosclerotic heart disease.
期刊介绍：
JACC: Cardiovascular Interventions is a specialist journal launched by the Journal of the American College of Cardiology (JACC). It covers the entire field of interventional cardiovascular medicine, including cardiac, peripheral, and cerebrovascular interventions. The journal publishes studies that will impact the practice of interventional cardiovascular medicine, including clinical trials, experimental studies, and in-depth discussions by respected experts. To enhance visual understanding, the journal is published both in print and electronically, utilizing the latest technologies.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
