病例系列:最小冠状动脉病变是扩张型心肌病的预后指标吗?

S. Kakroo, Y. Kishore
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引用次数: 1

摘要

本研究的目的是研究最小冠状动脉疾病(CAD)在扩张型心肌病(DCMP)患者的死亡率和心力衰竭住院率方面的预后意义。方法选取163例DCMP患者作为研究对象。其中,61.9% (n = 101;62.4%的男性患者没有相关的最小CAD, 38% (n = 62;66.1%男性)伴有最小CAD(狭窄< 50%),并记录其危险因素概况。这些患者随访30个月,以死亡率为主要终点,以心力衰竭形式继发于心脏失代偿的住院为次要终点。结果:年龄(p = 0.002)、高血压(p = 0.001)、糖尿病(p < 0.001)和吸烟(p = 0.023)是CAD的独立显著预测因素。最小CAD在DCMP患者中的存在作为死亡率的预测因子并不显著(优势比[OR]: 1.69, 95%可信区间[CI]: 0.62-4.62, p = 0.303);然而,它是继发于心脏失代偿住院的重要预测因子(OR: 6.78, 95% CI: 2.28-20.13, p = 0.001)。结论38%的DCMP患者有轻微的CAD。预测DCMP患者CAD的危险因素与一般人群相同。最小CAD在DCMP患者中的存在与死亡率无关。然而,它与继发于心力衰竭的心脏失代偿住院有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Case Series: Is Minimal Coronary Artery Disease a Prognostic Indicator in Dilated Cardiomyopathy?
Background The aim of this study was to study the prognostic implications of minimal coronary artery disease (CAD) in patients with dilated cardiomyopathy (DCMP) in terms of mortality and hospitalization due to heart failure. Methods One-hundred sixty-three patients with DCMP were recruited for this study. Out of these, 61.9% (n = 101; 62.4% men) patients were without associated minimal CAD and 38% (n = 62; 66.1% men) with associated minimal CAD (stenosis < 50%), and their risk factor profile was noted. These patients were followed for 30 months, with mortality being the primary endpoint, and hospitalization secondary to cardiac decompensation in the form of heart failure was denoted as the secondary endpoint. Results In our study, independent significant predictors of CAD were age (p = 0.002), hypertension (p = 0.001), diabetes (p < 0.001), and smoking (p = 0.023). The presence of minimal CAD in DCMP patients as a predictor of mortality was not significant (odds ratio [OR]: 1.69, 95% confidence interval [CI]: 0.62–4.62, p = 0.303); however, it was a significant predictor of hospitalization secondary to cardiac decompensation (OR: 6.78, 95% CI: 2.28–20.13, p = 0.001). Conclusions Minimal CAD was observed in 38% of DCMP patients. The risk factor profile predicting CAD in DCMP patients was the same as that of the general population. The presence of minimal CAD in DCMP patients was not associated with mortality. However, it was associated with hospitalization secondary to cardiac decompensation in the form of heart failure.
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