首页|中青年冠状动脉疾病患者药物洗脱支架植入术后主要不良心血管事件发生的影响因素分析

中青年冠状动脉疾病患者药物洗脱支架植入术后主要不良心血管事件发生的影响因素分析

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[目的]探讨中青年冠状动脉疾病(CAD)患者药物洗脱支架(DES)植入术后主要不良心血管事件(MACE)发生的影响因素.[方法]从Dryad数据库中提取郑州大学第一附属医院回顾性研究数据,根据随访期内是否发生MACE将接受DES的中青年CAD患者分为MACE组(n=57)和非MACE组(n=321).对比两组患者的年龄、性别等临床资料,将组间比较有显著差异的变量代入Logistic回归模型,筛选中青年CAD患者DES植入术后MACE发生的影响因素.绘制ROC曲线并计算曲线下面积(AUC)评价影响因素对中青年CAD患者DES植入术后MACE发生的预测价值.[结果]MACE组患者支架直径小于非MACE组(P<0.001),累及左主干数高于非MACE 组(P<0.05).多因素 Logistic 回归分析显示支架直径(OR=0.184,95%CI:0.084~0.405,P<0.001)和累及左主干(OR=9.319,95%CI:2.291~37.904,P=0.002)是中青年CAD患者DES植入术后发生MACE的影响因素.当支架直径>3 mm时,中青年CAD患者DES植入术后MACE发生的风险显著下降.支架直径和累及左主干联合预测中青年CAD患者DES植入术后发生MACE的AUC为0.700(95%CI:0.623~0.776).[结论]较小的支架直径和病变累及左主干是中青年CAD患者DES植入术后发生MACE的不良影响因素,临床工作者应给予重视.
Analysis of influencing factors of major adverse cardiovascular events after drug-eluting stent implantation in young and middle-aged patients with coronary artery disease
Aim To explore the influencing factors of major adverse cardiovascular events(MACE)after drug-e-luting stent(DES)implantation in young and middle-aged patients with coronary artery disease(CAD).Methods Retrospective study data from the First Affiliated Hospital of Zhengzhou University were extracted from the Dryad database,and young and middle-aged CAD patients who received DES were divided into MACE group(n=57)and non MACE group(n=321)according to whether MACE occurred during the follow-up period.Clinical data including age,gender etc.were compared between the two groups,and the variables with significant differences between the two groups were substitu-ted into Logistic regression model to screen the influencing factors of MACE after DES implantation in young and middle-aged CAD patients.Value of influencing factors predicting occurrence of MACE after DES implantation in young and mid-dle-aged CAD patients was evaluated by plotting ROC curve and calculating the area under the curve(AUC).Results Stent diameter in MACE group was significantly smaller than that in non MACE group(P<0.001),the number of left main coronary artery lesion in MACE group was significantly higher than that in non MACE group(P<0.05).Multivariate Lo-gistic regression analysis indicated that stent diameter(OR=0.184,95%CI:0.084~0.405,P<0.001)and left main coronary artery lesion(OR=9.319,95%CI:2.291~37.904,P=0.002)were the independent risk factors of MACE after DES implantation in young and middle-aged CAD patients.The risk of MACE after DES implantation in young and middle-aged CAD patients significantly decreased when the stent diameter was>3 mm.The AUC of stent diameter com-bined with left main coronary artery lesion predicting occurrence of MACE after DES implantation in young and middle-aged CAD patients was 0.700(95%CI:0.623~0.776).Conclusion The smaller stent diameter and left main coronary artery lesion are the influencing factors of the occurrence of MACE after DES implantation in young and middle-aged pa-tients with CAD,and should be emphasized by clinical practitioners.

coronary artery diseasedrug-eluting stentmajor adverse cardiovascular events

谷春景、朱昌国、孟昭昀

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济南市人民医院全科医学科,山东省济南市 271100

冠状动脉疾病 药物洗脱支架 主要不良心血管事件

山东省医药卫生科技发展计划项目

2018WS478

2024

中国动脉硬化杂志
中国病理生理学会 南华大学

中国动脉硬化杂志

CSTPCD
影响因子:1.086
ISSN:1007-3949
年,卷(期):2024.32(9)
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