JAHA:子痫前期病史女性冠状动脉再狭窄情况

2022-09-12 MedSci原创 MedSci原创

子痫前期病史与再狭窄风险增加无关,但有证据表明再狭窄风险降低。

尽管药物洗脱支架(DES)和设备的引入在过去20年取得了重大进展,但再狭窄仍然是经皮冠状动脉介入治疗(PCI)后的一个重要并发症。子痫前期病史与冠状动脉疾病风险增加相关,研究证据表明子痫前期病史也会增加再狭窄风险。然而,子痫前期病史在多大程度上与女性经皮冠状动脉介入治疗后再狭窄风险相关尚不清楚。

近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员纳入了2006年至2017年第一次经皮冠状动脉介入治疗的6065名年龄65岁以下的女性,并链接了瑞典全国经皮冠状动脉介入治疗和分娩史的数据。

该研究的主要结果为2年内临床再狭窄和靶病灶血运重建。研究人员在比例风险回归模型中考虑了冠脉节段、手术和患者相关的再狭窄潜在预测因子。345处节段(3.7%)发生再狭窄,383例(6.3%)患者进行了病灶血运重建。与正常妊娠史相比,子痫前期病史与再狭窄风险(预测风险比[HR]为0.71[95%CI为0.41-1.23])和目标病变血运重建(0.74[95%CI为0.51-1.07])均无显著相关性。当分别对足月子痫前期和早产子痫前期进行调查时,有足月子痫前期病史的女性再狭窄风险较低(预测因子占比为0.45[95%CI为0.21-0.94])。子痫前期病史与检查后2年内任何原因的死亡均无显著相关性(预测因子占比1.06,[95%CI为0.62-1.80])。

由此可见,子痫前期病史与再狭窄风险增加无关,但有证据表明再狭窄风险降低。为了促进未来的研究并允许重复,需要同时收集女性妊娠并发症史和经皮冠状动脉介入治疗结果的数据。

原始出处:

Annie Lin.et al.Coronary Artery Restenosis in Women by History of Preeclampsia.JAHA.2022.https://www.ahajournals.org/doi/10.1161/JAHA.122.026287

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