首页|主动脉瓣上狭窄术后早期心血管不良事件临床危险因素的回顾性队列研究

主动脉瓣上狭窄术后早期心血管不良事件临床危险因素的回顾性队列研究

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目的 明确主动脉瓣上狭窄(supravalvar aortic stenosis,SVAS)矫治术后早期主要心血管不良事件(major adverse cardiovascular events,MACEs)的危险因素.方法 纳入2002-2019年于北京及云南阜外医院接受手术矫治的SVAS患者.根据术后早期(住院期间和术后30 d内)是否发生MACEs,将患者分为MACEs组和non-MACEs组.获取患者术前、术中及术后临床资料,进行多因素logistic回归分析.结果 共纳入302例患者,其中男199例、女103例,中位年龄63.0(29.2,131.2)个月.SVAS矫治术后早期MACEs发生率为7.0%(21/302).多因素logistic回归分析显示,术后早期MACEs的独立危险因素为住ICU时间[OR=1.01,95%CI(1.00,1.01),P=0.032]、术中体外循环(cardiopulmonary bypass,CPB)时间[OR=1.02,95%CI(1.01,1.04),P=0.014]、主动脉瓣环直径[OR=0.65,95%CI(0.43,0.97),P=0.035]、主动脉窦内径[OR=0.75,95%CI(0.57,0.98),P=0.037]和狭窄部内径[OR=0.56,95%CI(0.35,0.90),P=0.016].结论 SVAS矫治术后早期MACEs的独立危险因素是住ICU时间、术中CPB时间、主动脉瓣环直径、主动脉窦内径和狭窄部内径.及早明确MACEs高危人群有利于临床治疗策略的制定.
Clinical risk factors for early adverse cardiovascular events after surgical correction of supravalvar aortic stenosis:A retrospective cohort study
Objective To identify clinical risk factors for early major adverse cardiovascular events(MACEs)following surgical correction of supravalvar aortic stenosis(SVAS).Methods Patients who underwent SV AS surgical correction between 2002 and 2019 in Beijing and Yunnan Fuwai Cardiovascular Hospitals were included.The patients were divided into a MACEs group and a non-MACEs group based on whether MACEs concurring during postoperative hospitalization or within 30 days following surgical correction for SVAS.Their preoperative,intraoperative,and postoperative clinical data were collected for multivariate logistic regression.Results This study included 302 patients.There were 199 males and 103 females,with a median age of 63.0(29.2,131.2)months.The incidence of early postoperative MACEs was 7.0%(21/302).The multivariate logistic regression model identified independent risk factors for early postoperative MACEs,including ICU duration(OR=1.01,95%CI 1.00-1.01,P=0.032),intraoperative cardiopulmonary bypass(CPB)time(OR=1.02,95%CI 1.01-1.04,P=0.014),aortic annulus diameter(OR=0.65,95%CI 0.43-0.97,P=0.035),aortic sinus inner diameter(OR=0.75,95%CI 0.57-0.98,P=0.037),and diameter of the stenosis(OR=0.56,95%CI 0.35-0.90,P=0.016).Conclusion The independent risk factors for early postoperative MACEs include ICU duration,intraoperative CPB time,aortic annulus diameter,aortic sinus inner diameter,and diameter of the stenosis.Early identification of high-risk populations for MACEs is beneficial for the development of clinical treatment strategies.

Congenital heart diseasesupravalvar aortic stenosissurgical treatmentadverse cardiovascular eventsrisk factors

章思梦、韦才奕、吕力知、彭博、夏简明、王强、闫军、史艺

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北京大学人民医院心外科(北京 100044)

北京大学基础医学院(北京 100191)

首都医科大学附属北京安贞医院小儿心脏外科中心(北京 100029)

中国医学科学院北京协和医学院国家心血管病中心阜外医院心脏外科(北京 100037)

云南省阜外心血管病医院心脏外科(昆明 650102)

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先天性心脏病 主动脉瓣上狭窄 外科治疗 心血管不良事件 危险因素

北京市科技新星交叉课题北京大学人民医院人才引进科研启动基金

202304844412022-T-01

2024

中国胸心血管外科临床杂志
四川大学华西医院

中国胸心血管外科临床杂志

CSTPCD北大核心
影响因子:0.846
ISSN:1007-4848
年,卷(期):2024.31(10)