冠状动脉血运重建术后患者侧支循环的决定因素及预后意义

来源 :世界核心医学期刊文摘(心脏病学分册) | 被引量 : 0次 | 上传用户:zhangzhao322
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
There is evidence that coronary collaterals improve the prognosis in patients with acute myocardial infarction(MI). However, there is limited clinical information on the protective role of collaterals in patients with stable coronary artery disease. This information may help risk stratification and the development of novel therapies, such as arteriogenesis and angiogenesis. The relation between collaterals and cardiac death or MI at 1 year after coronary revascularization was studied in 561 patients who were enrolled in a randomized study that compared stent implantation with bypass grafting. Collaterals were assessed on an angiogram using Rentrop’s classification and considered present with a Rentrop grade>1. Unadjusted and adjusted odds ratios for cardiac death or MI at 1 year were calculated using univariate and multivariate regression analyses. In addition, determinants of collaterals were assessed using univariate and multivariate analyses. Collaterals were present in 176 patients(31%). The adjusted odds ratio of cardiac death or infarction was 0.18(95%confidence interval 0.04 to 0.78) in the presence of collaterals. Independent determinants of collaterals were age(odds ratio 0.97, 95%confidence interval 0.95 to 0.99), multivessel disease(odds ratio 1.60, 95%confidence interval 1.02 to 2.51), impaired ventricular function(odds ratio 1.85, 95%confidence interval 1.04 to 3.29), type C lesion(odds ratio 3.72, 95%confidence interval 2.33 to 5.95), and stenosis severity >90%(odds ratio 9.08, 95%confidence interval 4.65 to 17.73). In conclusion, in patients with a low risk profile, the presence of collaterals protects against cardiac death and MI at 1 year after coronary revascularization. Variables that reflect the duration and severity of the atherosclerotic and ischemic burden determine their presence. There is evidence that the coronary collaterals improve the prognosis in patients with acute myocardial infarction (MI). However, there is limited the clinical information on the protective role of collaterals in patients with stable coronary artery disease. This information may help risk stratification and the development of novel therapies, such as arteriogenesis and angiogenesis. The relation between collaterals and cardiac death or MI at 1 year after coronary revascularization was studied in 561 patients who were enrolled in a randomized study that said stent implantation with bypass grafting. Collaterals were assessed on an angiogram using Rentrop’s classification and considered present with a Rentrop grade> 1. Unadjusted and adjusted odds ratios for cardiac death or MI at 1 year were calculated using univariate and multivariate regression analyzes. In addition, determinants of collaterals were assessed using univariate and multivariate analyzes. Collaterals were present in 176 patients (31%). The adjusted odds ratio of cardiac death or infarction was 0.18 (95% confidence interval 0.04 to 0.78) in the presence of collaterals. Independent determinants of collaterals were age (odds ratio 0.97, 95% confidence interval 0.95 to 0.99) , odds ratio 1.72, 95% confidence interval 1.02 to 2.51, impaired ventricular function (odds ratio 1.85, 95% confidence interval 1.04 to 3.29), type C lesion (odds ratio 3.72, 95% confidence interval 2.33 to 5.95) , and stenosis severity> 90% (odds ratio 9.08, 95% confidence interval 4.65 to 17.73). In conclusion, in patients with a low risk profile, the presence of collaterals protects against cardiac death and MI at 1 year after coronary revascularization. Variables that reflect the duration and severity of the atherosclerotic and ischemic burden determine their presence.
其他文献
合成了阳离子功能单体甲基丙烯酰氧乙基二甲基丁基溴化铵(DMB),并将DMB与丙烯酰胺(AM)共聚制备了阳离子聚丙烯酰胺,并用IR,NMR对其结构进行了表征。 The cationic functiona
摘 要:初中英语教师要使教学充满趣味性,增长学生的学习兴趣,运用教学智慧,全面提高教学效果。  关键词:初中英语 教学情味  初中英语教师要提高学生的学习兴趣,保持学生的学习动力,注重趣味教学,提高教学效率。  教师要创造和谐的师生关系,创造轻松愉悦的环境,采用灵活的教学方法,激发学生的学习兴趣,改进教学模式,追求教学效果,推进英语教学。  一、 创造和谐的师生关系  教师要创造和谐的师生关
樟子松是我国稀有的珍贵树种,具有耐寒、耐旱、耐贫瘠的特性,素有防风固沙先锋树种之称。由于它适应性强、生长迅速、材质良好,在“三北”地区可以广泛种植,目前已越来越引
根据我场多年来的造林实践,传统的造林成活率(可理解为造林实际成活率),从其概念到计算方法以及应用,已不能完全适应复杂多样的林业生产活动。在造林作业中若以造林成活率推
本文以系统的观点分析了一阶电路的完全响应.一阶电路的求解方法、物理意义和教学分析在本文中都有详尽的阐述. This paper analyzes the complete response of the first-o
自治区党委和区人民政府作出《关于保护森林、发展林业,十五年基本绿化全区的决定》(下称《决定》),是我区林业建设发展的一项重大战略决策。而森林资源建设是林业发展的核
座落在凉城县岱海滩上的六苏木乡,过去是黄沙遍地,每当刮大风时,天昏地暗,白天屋里还得点灯。从1973年开始,这个乡的群众在乡党委和政府的领导下,大力营造农田防护林,改善了
湖南省林地主要分布在中亚热带低山丘陵,属中亚热带常绿阔叶林地带,多为混交次生林,年平均气温16—18℃,≥10℃积温为5000—5800℃,年降水量为1200—1700毫米,属亚热带温暖
湿地松(Pinus Clli-ottii Englem)原产美国,因其生长快、杆形通直、适应性广、产脂量高、用途广泛。我国长江以南省份已广为引种栽培。近年,各地为了实现种子自给,纷纷选择
甜杨(populusSuaveolons)是杨柳科杨属中野生的高大乔木。它分布在内蒙古大兴安岭北部林区河流沿岸,对防风护岸有良好作用。我公司种子园苗圃,为了充分利用当地野主的优良杨