冠状动脉内旋磨术术中并发症及术后12个月内主要不良心血管事件的影响因素分析

Potential factors influencing complications during rotational atherectomy and major adverse cardiovascular events within 12 months

目的:探讨冠状动脉内旋磨术(RA)术中并发症及术后12个月内主要不良心血管事件(MACE)的影响因素。方法:回顾性分析2017年1月至2020年12月宜宾市第一人民医院和宜宾市第三人民医院收治的316例行RA的患者,收集临床病例资料,采用多因素logistic回归分析术中并发症和术后12个月内MACE的影响因素。结果:RA术中并发症和术后12个月内MACE的发生率分别为15.8%和22.9%,多因素分析显示心力衰竭史、SYNTAX评分及旋磨头血管内径比是RA术中并发症的影响因素(P均<0.05);RA术后12个月MACE的影响因素包括高血压史、SYNTAX评分、术后6个月低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(HbA1c)水平和最小管腔直径(MLD)(P均<0.05)。结论:RA术中并发症可能与心力衰竭史、SYNTAX评分及旋磨头血管内径比有关,而高血压史、SYNTAX评分、术后6个月LDL-C、HbA1c水平和MLD则可能是术后12个月内MACE发生的独立预测因素。

Objective:To explore the possible factors related to complications during rotational atherectomy(RA)and major adverse cardiac events(MACE)within 12 months after the procedure.Methods:Clinical data of 316 patients who underwent RA at The First People's Hospital of Yibin and The Third People's Hospital of Yibin from January 2017 to December 2020 were retrospectively collected.Multivariate logistic regression analysis was performed to determine the factors which could influence the occurrence of complications during RA and MACE within 12 months after the procedure.Results:In total,the incidence of complications during RA and MACE within 12 months after the procedure were 15.8%and 22.9%,respectively.Multivariable analysis showed that history of heart failure,SYNTAX score,and vessel to burr diameter ratio were determinants for complications during RA(P<0.05).And,history of hypertension,SYNTAX score,low-density lipoprotein cholesterol(LDL-C)concentration within 6 months,glycosylated hemoglobin(HbA1c),and minimum lumen diameter(MLD)were determinants for MACE within 12 months after the procedure.Conclusion:Intraoperative complications of RA may be related to history of heart failure,SYNTAX score,and burr size.Whereas MACE within 12 months after intervention could be influenced by history of hypertension,SYNTAX score,LDL-C concentration within 6 months,HbA1c,and MLD.