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Heart：冠脉侧枝循环或无益于ACS患者转归

2013-12-16 高晓方 译 医学论坛网

冠脉侧枝循环ACS患者转归影响
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英国一项研究表明，在急性冠脉综合征（ACS）患者中，冠脉侧枝循环的存在对临床转归并无有益影响，甚至有可能增加患者死亡率；并且在PCI患者中可能与靶血管血运重建风险升高相关。论文12月5日在线发表于《心脏》（Heart）。 此项研究共纳入5412例中、高危ACS患者，并由独立血管造影中心利用Rentrop评分评估冠脉侧枝循环。评估冠脉侧枝循环对ACS患者临床转归的预测作用。临床转归由严重不

英国一项研究表明，在急性冠脉综合征（ACS）患者中，冠脉侧枝循环的存在对临床转归并无有益影响，甚至有可能增加患者死亡率；并且在PCI患者中可能与靶血管血运重建风险升高相关。论文12月5日在线发表于《心脏》（Heart）。

此项研究共纳入5412例中、高危ACS患者，并由独立血管造影中心利用Rentrop评分评估冠脉侧枝循环。评估冠脉侧枝循环对ACS患者临床转归的预测作用。临床转归由严重不良心脏事件（MACE）、死亡、心肌梗塞和计划外靶血管血运重建（TVR）组成。

结果显示，858例（16.0%）患者伴有可见侧枝循环，4554例（84.0%）患者无侧枝循环。多变量校正之后，两组患者的1年临床转归无显著差异，其中MACE、死亡、心梗和计划外TVR的危险比（HR）分别为0.94、1.03、1.07和0.95。与之相似，在接受经皮冠脉介入（PCI）的亚组患者中，MACE、死亡和心梗的校正HR分别为1.1、0.81和0.86。计划外TVR风险则出现升高（HR 2.74）。

原文出处：

Meier P, Lansky AJ, Fahy M, Xu K, White HD, Bertrand ME, Mehran R, Stone GW.The impact of the coronary collateral circulation on outcomes in patients with acute coronary syndromes: results from the ACUITY trial.Heart. 2013 Dec 5. doi: 10.1136/heartjnl-2013-304435. 

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    2013-12-18 yaanren

    #ACS#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1279036, encodeId=935d12e903655, content=<a href='/topic/show?id=316d1882bc' target=_blank style='color:#2F92EE;'>#ACS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1882, encryptionId=316d1882bc, topicName=ACS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=102a153, createdName=yaanren, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355814, encodeId=89091355814fb, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562200, encodeId=2e61156220056, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1574962, encodeId=6bc715e496285, content=<a href='/topic/show?id=52ab188e48' target=_blank style='color:#2F92EE;'>#ACS患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1887, encryptionId=52ab188e48, topicName=ACS患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bf9f16042984, createdName=neurosurgeon, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=)]
    2013-12-18 zhaojie88

    #ART#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1279036, encodeId=935d12e903655, content=<a href='/topic/show?id=316d1882bc' target=_blank style='color:#2F92EE;'>#ACS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1882, encryptionId=316d1882bc, topicName=ACS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=102a153, createdName=yaanren, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355814, encodeId=89091355814fb, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562200, encodeId=2e61156220056, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1574962, encodeId=6bc715e496285, content=<a href='/topic/show?id=52ab188e48' target=_blank style='color:#2F92EE;'>#ACS患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1887, encryptionId=52ab188e48, topicName=ACS患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bf9f16042984, createdName=neurosurgeon, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=)]
    2013-12-18 爆笑小医

    #HEART#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1279036, encodeId=935d12e903655, content=<a href='/topic/show?id=316d1882bc' target=_blank style='color:#2F92EE;'>#ACS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1882, encryptionId=316d1882bc, topicName=ACS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=102a153, createdName=yaanren, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355814, encodeId=89091355814fb, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1562200, encodeId=2e61156220056, content=<a href='/topic/show?id=f69d864413' target=_blank style='color:#2F92EE;'>#HEART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8644, encryptionId=f69d864413, topicName=HEART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1574962, encodeId=6bc715e496285, content=<a href='/topic/show?id=52ab188e48' target=_blank style='color:#2F92EE;'>#ACS患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1887, encryptionId=52ab188e48, topicName=ACS患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bf9f16042984, createdName=neurosurgeon, createdTime=Wed Dec 18 05:55:00 CST 2013, time=2013-12-18, status=1, ipAttribution=)]
    2013-12-18 neurosurgeon

    #ACS患者#

    0