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JAHA:阻塞性和非阻塞性急性冠脉综合征的比较

2016-12-17 haofan MedSci原创

非阻塞性急性冠脉综合征患者具有显著降低的基础心血管疾病风险和后续较低的死亡或主要心血管事件几率。然而,这些患者仍然是心血管疾病发病率和死亡率高风险对象,这表明存在治疗不充足的情况和需要更加专业的管理。

已有研究证实在急性冠脉综合征患者中阻塞性和非阻塞性在预后和基础临床表现方面存在明显不同,但是在单一研究中事件发生率在很大程度上变化不一。近日,心血管病领域权威杂志JAHA(IF:5.117)上发表了一篇文章,研究人员进行了一项荟萃分析比较了与阻塞性和非阻塞性急性冠状动脉综合征患者以及轻度阻塞患者和无阻塞患者的预后和临床表现。

研究人员通过检索MEDLINE、EMBASE、Cochrane数据库以及国际会议的摘要,日期到2015年6月30日截止。研究者使用随机效应Meta分析比较了阻塞性和非阻塞性急性冠脉综合征事件发生的风险。研究人员还进行了Meta分析来估计每个组每年或每月结局事件的发生率。


阻塞性和非阻塞性急性冠脉综合征患者合并年度发生率分别为:2.4% vs. 10.1%(全因死亡率);1.2%vs. 6%(心肌梗死);4% vs. 12.8%(全因死亡率加上心肌梗死);1.4% vs. 5.9%(心脏死亡);以及9.2% vs. 16.8%(主要心血管事件)。在直接比较阻塞性和非阻塞性急性冠脉综合征的研究中,以上结果在非阻塞性急性冠脉综合征患者中发生频率显著降低(风险比率从0.33变到了0.66)。任何结局事件发生率在轻度闭塞(1-49%的狭窄)和无闭塞患者之间无显着差异。

由此可见,非阻塞性急性冠脉综合征患者具有显著降低的基础心血管疾病风险和后续较低的死亡或主要心血管事件几率。然而,这些患者仍然是心血管疾病发病率和死亡率高风险对象,这表明存在治疗不充足的情况以及需要更加专业的管理。

原始出处:

Carmine Pizzi, et al. Nonobstructive Versus Obstructive Coronary Artery Disease in Acute Coronary Syndrome: A Meta‐Analysis.  JAHA. December 16, 2016.

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

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    2017-09-15 tomyang96
  2. [GetPortalCommentsPageByObjectIdResponse(id=1696691, encodeId=4f39169669169, content=<a href='/topic/show?id=d2e99e651e4' target=_blank style='color:#2F92EE;'>#阻塞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97651, encryptionId=d2e99e651e4, topicName=阻塞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a23129903429, createdName=tomyang96, createdTime=Fri Sep 15 18:21:00 CST 2017, time=2017-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=164015, encodeId=2975164015a4, content=文章不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Mon Dec 19 09:27:17 CST 2016, time=2016-12-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267353, encodeId=64ea126e3535e, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Mon Dec 19 09:21:00 CST 2016, time=2016-12-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1430733, encodeId=c4ad1430e33ee, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Mon Dec 19 09:21:00 CST 2016, time=2016-12-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=163920, encodeId=6816163920ce, content=谢谢啦, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K46ZAxBHmHsph32KkfsWGwmickB6RsCUD8KruE4vo5CpvXfdu16GBpp4ibh6WJu1o9iatP1LWKDmvmic/0, createdBy=be6f1940165, createdName=1e0ece0dm09(暂无匿称), createdTime=Mon Dec 19 00:11:34 CST 2016, time=2016-12-19, status=1, ipAttribution=)]
    2016-12-19 1e10c84am36(暂无匿称)

    文章不错

    0

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    2016-12-19 zhaohui6731
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    2016-12-19 1e0ece0dm09(暂无匿称)

    谢谢啦

    0

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急性冠状动脉综合征(ACS)是一种常见的严重的心血管疾病,是冠心病的一种严重类型。常见于老年、男性及绝经后女性、吸烟、高血压、糖尿病、高脂血症、腹型肥胖及有早发冠心病家族史的患者。ACS患者常常表现为发作性胸痛、胸闷等症状,可导致心律失常、心力衰竭、甚至猝死,严重影响患者的生活质量和寿命。如及时采取恰当的治疗方式,则可大大降低病死率,并减少并发症,改善患者的预后。本文梅斯医学小编为大家盘点相关

2016CCS循证建议——急性冠脉综合征出院后的二级预防发布

2016年6月,加拿大心血管学会(CCS)发布了急性冠脉综合症出院后的二级预防建议,该建议涉及的内容包括:血管保护,心脏保护,危险因素控制,患者依从性等。全文获取:下载地址:指南下载(需要扣积分2分, 梅斯医学APP免积分下载) 

2016SIGN国家临床指南——急性冠脉综合征(148)发布

2016年4月,苏格兰校际指南网络(SIGN)制定了急性冠脉综合征指南。全文获取:

GW-ICC 2016:ACS 抗栓出血应对策略

抗栓是急性冠脉综合征(ACS)药物治疗的基石。然而抗栓相关出血并发症日渐突出。“第一直播间”请到《急性冠状动脉综合征抗栓治疗合并出血防治多学科专家共识》(下称“共识”)发起人之一北京安贞医院急诊危重症中心聂绍平教授及核心专家北京协和医院沈珠军教授和北京安贞医院消化内科张杰教授,共同探讨此类患者的应对策略。聂绍平教授说,出血并发症已成为阻碍ACS患者抗栓治疗获益的“拦路虎”,而ACS抗栓合并出血的处

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