[1]叶滔 成联超 崔彩艳 童兰 张震 童琳 蔡琳.残余SYNTAX评分在高龄冠状动脉粥样硬化性心脏病介入患者中的应用价值分析[J].心血管病学进展,2024,(12):1133.[doi:10.16806/j.cnki.issn.1004-3934.2024.12.017]
　YE Tao,CHENG Lianchao,CUI Caiyan,et al.Application Value of Residual SYNTAX Score in elderly Coronary Artery Disease Patients With Percutaneous Coronary Intervention[J].Advances in Cardiovascular Diseases,2024,(12):1133.[doi:10.16806/j.cnki.issn.1004-3934.2024.12.017]
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残余SYNTAX评分在高龄冠状动脉粥样硬化性心脏病介入患者中的应用价值分析()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2024年12期
页码:
1133
栏目:
论著
出版日期:
2024-12-25

文章信息/Info

Title:
Application Value of Residual SYNTAX Score in elderly Coronary Artery Disease Patients With Percutaneous Coronary Intervention
作者:
叶滔 成联超 崔彩艳 童兰 张震 童琳 蔡琳
?西南交通大学附属医院 成都市第三人民医院心内科 成都市心血管病研究所,四川 成都 610031)
Author(s):
YE Tao; CHENG Lianchao; CUI Caiyan; TONG Lan; ZHANG Zhen; TONG Lin; CAI Lin
(Department of Cardiology,The Third People’s Hospital of Chengdu,Affiliated Hospital of Southwest Jiaotong University,Cardiovascular Disease Research Institute of Chengdu,Chengdu 610031,Sichuan,China)
关键词:
经皮冠状动脉介入治疗; 残余SYNTAX评分; 预后
Keywords:
Percutaneous coronary intervention; Residual SYNTAX score; Prognosis
DOI:
10.16806/j.cnki.issn.1004-3934.2024.12.017
摘要:
目的 经皮冠状动脉介入治疗(PCI)术后残余SYNTAX评分(rSS)可作为不完全血运重建程度的量化指标，现旨在评估rSS在行PCI的高龄（年龄≥75岁）冠状动脉粥样硬化性心脏病（CAD）患者中临床预后的预测价值。方法 纳入 2018年1月—2019年12月就诊于成都市第三人民医院行PCI治疗的患者1 081例，按年龄将患者分为年龄＜75岁和年龄≥75岁两组，根据rSS将患者分为3组（rSS=0、1≤rSS≤8、rSS≥9）。临床随访18个月，临床终点事件包括主要不良心血管事件(MACE）（全因死亡、心肌梗死和再次血运重建的复合终点)，比较rSS在高龄和年龄＜75岁患者中临床预后的预测价值。结果 所有1 081例患者中，高龄患者309例（28.58%），高龄患者体重指数更低、合并症更多、基线SYNTAX评分更高、rSS更高（P＜0.001）。在高龄和年龄＜75岁的患者中，随着rSS增高，MACE发生率均增高（P＜0.001）。多因素的logistic回归分析显示，rSS是MACE的独立预测因素（P＜0.05）。结论 对于高龄（年龄≥75岁）CAD患者，rSS是临床预后的独立预测因素。不完全血运重建程度越高，患者预后越差。
Abstract:
Objective The residual SYNTAX score (rSS) can be used as a quantitative indicator of the degree of incomplete revascularization in coronary atherosclerotic heart disease(CAD) undergoing percutaneous coronary intervention ( PCI) . The purpose of this study was to evaluate the predictive value of rSS for clinical outcomes in elderly (age≥75 years) CAD patients undergoing PCI. Methods A total of 1 081 patients undergoing PCI treatment at the Third People’s Hospital of Chengdu from January 2 018 to December 2019 were included. The patients were divided into two groups (age<75 years old and age≥75 years old) according to age,and divided into three groups (rSS=0,1≤rSS≤8,and rSS≥9) according to rSS. The clinical follow-up was 18 months, and the c linical end points included major adverse cardiovascular events (MACE),a composite event of all-cause death,myocardial infarction,and revascularization). The prognostic value of rSS in elderly and age <75 years old patients was compared. Results Among the 1 081 patients,309 (28.58%) were elderly,and elderly had lower body mass index,more comorbidities,higher baseline SYNTAX score,and higher rSS (P< 0.001). The incidence of MACE increased with increasing rSS in both elderly and age<75 years old (P< 0.001) patients. Multivariate logistic regression analysis showed that rSS was an independent predictor of MACE (P<0.05). Conclusion RSS is an independent predictor of clinical outcome in elderly (age≥75 years old) co ronary heart disease patients with PCI,similar to those < 75 years old . The higher the degree of incomplete revascularization,the worse the prognosis

参考文献/References:

[1].中华医学会心血管病学分会,中华心血管病杂志编辑委员会. 非ST段抬高型急性冠脉综合征诊断和治疗指南（2024）[J]. 中华心血管病杂志,2024,52(6):615-646.
[2].Rathod KS,Koganti S,Jain AK,et al. Complete Versus Culprit-Only Lesion Intervention in Patients With Acute Coronary Syndromes[J]. J Am Coll Cardiol,2018,72(17):1989-1999.
[3].Farooq V,Serruys PW,Bourantas CV,et al. Quantification of incomplete revascularization and its association with five-year mortality in the synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) trial validation of the residual SYNTAX score[J]. Circulation,2013,128(2):141-151.
[4].Rosner GF,Kirtane AJ,Genereux P,et al. Impact of the presence and extent of incomplete angiographic revascularization after percutaneous coronary intervention in acute coronary syndromes :the Acute Catheterization and Urgent Intervention Triage Strategy (ACUITY) trial[J]. Circulation,2012,125(21):2613-2620.
[5].高晓津,杨进刚,杨跃进,等. 中国急性心肌梗死患者不同年龄组心血管危险因素分析[J]. 中华医学杂志,2016,96(40):3251-3256.
[6].中国老年医学学会心血管病分会. 高龄老年(≥75岁)急性冠状动脉综合征患者规范化诊疗中国专家共识[J]. 中国循环杂志,2018,33(8):732-750.
[7].Sandoval Y,Brilakis ES,Canoniero M,et al. Complete versus incomplete coronary revascularization of patients with multivessel coronary artery disease[J]. Curr Treat Options Cardiovasc Med,2015,17(3):366.
[8].Dauerman HL. Reasonable incomplete revascularization[J]. Circulation,2011,123(21):2337-2340.
[9].Généreux P,Palmerini T,Caixeta A,et al. Quantification and impact of untreated coronary artery disease after percutaneous coronary intervention:the residual SYNTAX (Synergy Between PCI with Taxus and Cardiac Surgery) score[J]. J Am Coll Cardiol,2012,59(24):2165-2174.
[10].Knuuti J,Wijns W,Saraste A,et al. ESC Scientific Document Group,2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes[J]. Eur Heart J,2020,1(3):407-477.
[11].中华医学会心血管病学分会,中华心血管病杂志编辑委员会. 急性ST段抬高型心肌梗死诊断和治疗指南(2019)[J]. 中华心血管病杂志,2019,47(10):766-783.
[12].Gaba,P,Gersh,B.J,Ali,Z.A,et al. Complete versus incomplete coronary revascularization:definitions,assessment and outcomes[J]. Nat Rev Cardiol,2021,18(3):155-168.
[13].Lemor A,Basir MB,Patel K,et al. Multivessel Versus Culprit-Vessel Percutaneous Coronary Intervention in Cardiogenic Shock[J]. JACC Cardiovasc Interv ,2020,13(10):1171-1178.
[14].Aboul-Hassan SS,Awad AK,Stankowski T,et al. Impact of Incomplete Revascularization on Long-term Survival Based on Revascularization Strategy[J]. Ann Thorac Surg,2024,118(3):605-614.
[15].Thiele H,Akin I,Sandri M,et al. One-year outcomes after PCI strategies in cardiogenic shock[J]. N Engl J Med,2018,379(18):1699-1710.
[16].Girerd N,Magne J,Rabilloud M,et al. The impact of complete revascularization on long-term survival is strongly dependent on age[J]. Ann Thorac Surg ,2012,94(4):1166-1172.
[17].王焕欣,王素华,刘红梅. SYNTAX评分和rSS评分对老年STEMI患者PCI治疗后不良预后的预测价值比较[J]. 岭南心血管病杂志,2022,28(3):237-240,245.
[18].Wang TY,McCoy LA,Bhatt DL,et al. Multivessel vs culprit-only percutaneous coronary intervention among patients 65 years or older with acute myocardial infarction[J]. Am Heart J,2016,172:9-18.
[19].Ilardi F,Ferrone M,Avvedimento M,et al. Complete Revascularization in Acute and Chronic Coronary Syndrome[J]. Cardiol Clin,2020,38(4):491-505.

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更新日期/Last Update: 2025-01-08