心血管康复医学杂志2024,Vol.33Issue(3) :261-264.DOI:10.3969/j.issn.1008-0074.2024.03.01

高血压史与急性冠脉综合征患者远期冠脉不良预后的关系

Relationship between hypertension history and long-term coronary adverse prognosis in patients with acute coronary syndrome

董梦雅 徐晨博 周娟 袁祖贻
心血管康复医学杂志2024,Vol.33Issue(3) :261-264.DOI:10.3969/j.issn.1008-0074.2024.03.01

高血压史与急性冠脉综合征患者远期冠脉不良预后的关系

Relationship between hypertension history and long-term coronary adverse prognosis in patients with acute coronary syndrome

董梦雅 1徐晨博 2周娟 3袁祖贻4
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作者信息

  • 1. 陕西省人民医院心血管内二科,陕西西安 710068
  • 2. 西安交通大学第一附属医院心血管内科
  • 3. 西安交通大学第一附属医院心血管内科;环境与疾病相关教育部重点实验室
  • 4. 西安交通大学第一附属医院心血管内科;陕西省分子心脏病学重点实验室
  • 折叠

摘要

目的:分析高血压史与急性冠脉综合征(ACS)患者远期冠脉不良预后的关系.方法:本研究为回顾性单中心观察性研究.连续收集2013年1月至2014年2月在西安交通大学第一附属医院心血管内科住院,临床确诊的ACS并接受冠状动脉造影(CAG)检查的患者385例作为研究对象.缺血事件定义为再次血运重建、支架内血栓、支架内再狭窄和活动性心绞痛.采用Kaplan-Meier生存曲线和Cox回归分析来研究高血压史与ACS患者远期冠脉不良预后的关系.结果:根据高血压史的中位数,385例患者被分为高血压史≤1年组(201例)和高血压史>1年组(184例).在随访2.6(2.3,2.8)年后,高血压史≤1年组和高血压史>1年组分别有39例(19.4%)、46例(25.0%)发生了缺血事件.Kaplan-Meier生存曲线分析提示高血压史>1年组的缺血事件发生率显著高于高血压史≤1年组(x2=4.675,P=0.031).在调整了可能的混杂因素后,多元Cox回归分析提示高血压史仍是ACS患者缺血事件的独立危险因素(HR=1.033,95%CI 1.008-1.057,P=0.008).结论:高血压史是急性冠脉综合征患者发生远期缺血事件的独立危险因素;并且随着高血压史时间延长,发生缺血事件的风险显著增加.

Abstract

Objective:To analyze the relationship between hypertension history and long-term coronary adverse prognosis in patients with acute coronary syndrome(ACS).Methods:The study was a retrospective,single-center,observational research.A total of 385 patients,who admitted in Department of Cardiology of First Affiliated Hos-pital of Xi'an Jiaotong University from January 2013 to February 2014,diagnosed as ACS and received coronary an-giography(CAG),were continuously collected.Ischemic events were defined as revascularization,in-stent throm-bosis,in-stent restenosis and active angina.Kaplan-Meier survival curve and Cox regression analysis were used to determine the relationship between hypertension history and long-term coronary adverse prognosis in ACS pa-tients.Results:The 385 patients were divided into hypertension history ≤1 year group(n=201)and hypertension history>1 year group(n=184)according to the median of hypertension history.After follow-up of 2.6(2.3,2.8)years,39 cases(19.4%)and 46 cases(25.0%)suffered from ischemic events in hypertension history ≤1 year group and hypertension history>1 year group respectively.Kaplan-Meier survival curve analysis revealed that the incidence rate of ischemic events in hypertension history>1 year group was significantly higher than that of hyper-tension history ≤1 year group(x2=4.675,P=0.031).After adjusting possible confounding factors,multivariable Cox regression analysis indicated that hypertension history remained an independent risk factor of ischemic events in ACS patients(HR=1.033,95%CI 1.008-1.057,P=0.008).Conclusion:Hypertension history is an independent risk factor for long-term ischemic events in patients with acute coronary syndrome.And the risk of ischemic e-vents is significantly increasing with the longer hypertension history.

关键词

急性冠状动脉综合征/高血压/心肌缺血/危险因素

Key words

Acute coronary syndrome/Hypertension/Myocardial ischemia/Risk factors

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出版年

2024
心血管康复医学杂志
福建省康复医学会 中国康复医学会

心血管康复医学杂志

CSTPCD
影响因子:1.157
ISSN:1008-0074
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