Background The Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery （SYNTAX）-score is a validated tool for risk stratification and revascularization strategy selection in patients with c...Background The Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery （SYNTAX）-score is a validated tool for risk stratification and revascularization strategy selection in patients with complex coronary artery disease. The aim of this study was to analyse its age-related prognostic value. Methods SYNTAX-score was calculated in 1331 all-comer patients undergoing percutaneous coronary intervention （PCI）： 463 patients ≥ 75 years and 868 patients 〈 75 years. Outcomes of interest were all-cause mortality at one and two years. Results A significant interaction of age and SYNTAX-score for mortality was observed at two-year （Pinteraction= 0.019） but not at one-year follow-up （Pinteraction= 0.594）. In multivariable analysis, SYNTAX-score independently predicted 1-year mortality in both age groups （〈 75 years, hazard ratio （HR）： 1.43, 95% confidence intervals （CI）： 1.03-2.00, P = 0.034; and 〉 75 years, HR： 1.37, 95% CI： 1.01-1.85, P = 0.042）, but only two-year mortality among younger patients （〈 75 years, HR： 1.33, 95% CI： 1.01-1.76, P = 0.041; and ≥ 75 years, HR： 1.11, 95% CI： 0.87-1.41, P = 0.394）. SYNTAX-score tertiles were useful to stratify 1-year mortality in both, patients 〈 75 years （SYNTAX-score 〈 9, 3.8%; 9-20, 5.3%; 〉 20, 10.3%; P = 0.004） and 〉 75 years （SYNTAX-score 〈 11, 5.7%; 11-22.5, 16.1%; 〉 22.5, 18.7%; P = 0.003）, but two-year mortality only among patients 〈 75 years （SYNTAX-score 〈 9, 6.5%; 9-20, 7.6%; ≥ 20, 15%; P 〈 0.001） and not among ≥ 75 years old patients （SYNTAX-score 〈 11, 19.4%; 11-22.5, 26.3%; _〉 22.5, 27.9%; P = 0.138）. Conclusions Age modi- fies the impact of the SYNTAX-score on longer-term mortality after PCI. Among patients 〈 75 years, the SYNTAX-score independently predicts the risk of death at one and two years after PCI, while among patients 〉 75 years its predictive role is limited to the first year after PCI. Further studies are needed to evaluate the value of SYNTAX-score for selecting the most appropriate revascularization strategy among elderly patients.展开更多
目的探究居家运动康复对不同程度冠状动脉血运重建患者心肺功能的影响。方法从心脏康复中心数据库中选择2020年9月—2022年9月确诊为急性冠脉综合征并行经皮冠状动脉介入治疗,术后行居家运动康复的患者93例。依据剩余syntax评分(rSS)将...目的探究居家运动康复对不同程度冠状动脉血运重建患者心肺功能的影响。方法从心脏康复中心数据库中选择2020年9月—2022年9月确诊为急性冠脉综合征并行经皮冠状动脉介入治疗,术后行居家运动康复的患者93例。依据剩余syntax评分(rSS)将患者分为rSS<8分组51例和rSS≥8分组42例。采用心肺功能运动试验(CPET)评估心肺功能,比较两组患者居家运动康复前及居家运动康复6个月后CPET参数的变化。结果居家运动康复6个月后,两组患者无氧阈时的氧摄取量(VO_(2)at AT)、峰值氧摄取量(VO_(2)at peak)、无氧阈时的氧脉率(VO_(2)/HR at AT)、峰值氧脉率(VO_(2)/HR at peak)较居家运动康复前升高,差异均有显著性(t=-2.953~-5.483,P<0.05)。两组患者居家运动康复前后无氧阈时的二氧化碳通气效率(VE/VCO_(2)at AT)的差值、峰值二氧化碳通气效率(VE/VCO_(2)at peak)差值比较差异有显著性(Z=-2.046、-2.206,P<0.05)。结论居家运动康复可以改善经皮冠状动脉介入治疗术后急性冠脉综合征患者的心肺功能,且居家运动康复对rSS≥8分的患者心功能获益更显著。展开更多
This study explores the predictive value of plasma a disintegrin and metalloproteinase with thrombospondin motifs 5 (ADAMTS-5) levels for major adverse cardiovascular events (MACE) in patients with coronary artery dis...This study explores the predictive value of plasma a disintegrin and metalloproteinase with thrombospondin motifs 5 (ADAMTS-5) levels for major adverse cardiovascular events (MACE) in patients with coronary artery disease (CAD). 595 patients admitted to our hospital were selected. Initially, the serum ADAMTS-5 levels of subjects were analyzed. Subsequently, a receiver operating characteristic (ROC) curve was constructed. Furthermore, the serum levels of ADAMTS-5 were assessed in patients, and based on CAD severity, they were categorized into stable angina pectoris (SAP), unstable angina (UA), non-ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI) groups, with the aim of examining the relationship between ADAMTS-5 levels and CAD severity. Differences in clinical outcomes between patients with high and low levels of ADAMTS-5 were analyzed during the follow-up period. The study found that the serum levels of ADAMTS-5 were significantly higher in the group of patients with coronary artery disease (CAD) compared to the group without CAD, indicating its potential as a diagnostic marker for CAD. The ADAMTS-5 levels in the serum of STEMI patients were higher than those with SAP, while NSTEMI patients showed higher levels of ADAMTS-5 than the UA group. There was a positive correlation between serum ADAMTS-5 levels and the syntax score in CAD patients, suggesting a potential association with adverse clinical outcomes in patients with acute myocardial infarction (AMI). This study indicates that ADAMTS-5 shows promise as a biomarker for CAD and highlights the need for further research and validation.展开更多
文摘Background The Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery （SYNTAX）-score is a validated tool for risk stratification and revascularization strategy selection in patients with complex coronary artery disease. The aim of this study was to analyse its age-related prognostic value. Methods SYNTAX-score was calculated in 1331 all-comer patients undergoing percutaneous coronary intervention （PCI）： 463 patients ≥ 75 years and 868 patients 〈 75 years. Outcomes of interest were all-cause mortality at one and two years. Results A significant interaction of age and SYNTAX-score for mortality was observed at two-year （Pinteraction= 0.019） but not at one-year follow-up （Pinteraction= 0.594）. In multivariable analysis, SYNTAX-score independently predicted 1-year mortality in both age groups （〈 75 years, hazard ratio （HR）： 1.43, 95% confidence intervals （CI）： 1.03-2.00, P = 0.034; and 〉 75 years, HR： 1.37, 95% CI： 1.01-1.85, P = 0.042）, but only two-year mortality among younger patients （〈 75 years, HR： 1.33, 95% CI： 1.01-1.76, P = 0.041; and ≥ 75 years, HR： 1.11, 95% CI： 0.87-1.41, P = 0.394）. SYNTAX-score tertiles were useful to stratify 1-year mortality in both, patients 〈 75 years （SYNTAX-score 〈 9, 3.8%; 9-20, 5.3%; 〉 20, 10.3%; P = 0.004） and 〉 75 years （SYNTAX-score 〈 11, 5.7%; 11-22.5, 16.1%; 〉 22.5, 18.7%; P = 0.003）, but two-year mortality only among patients 〈 75 years （SYNTAX-score 〈 9, 6.5%; 9-20, 7.6%; ≥ 20, 15%; P 〈 0.001） and not among ≥ 75 years old patients （SYNTAX-score 〈 11, 19.4%; 11-22.5, 26.3%; _〉 22.5, 27.9%; P = 0.138）. Conclusions Age modi- fies the impact of the SYNTAX-score on longer-term mortality after PCI. Among patients 〈 75 years, the SYNTAX-score independently predicts the risk of death at one and two years after PCI, while among patients 〉 75 years its predictive role is limited to the first year after PCI. Further studies are needed to evaluate the value of SYNTAX-score for selecting the most appropriate revascularization strategy among elderly patients.
文摘目的探究居家运动康复对不同程度冠状动脉血运重建患者心肺功能的影响。方法从心脏康复中心数据库中选择2020年9月—2022年9月确诊为急性冠脉综合征并行经皮冠状动脉介入治疗,术后行居家运动康复的患者93例。依据剩余syntax评分(rSS)将患者分为rSS<8分组51例和rSS≥8分组42例。采用心肺功能运动试验(CPET)评估心肺功能,比较两组患者居家运动康复前及居家运动康复6个月后CPET参数的变化。结果居家运动康复6个月后,两组患者无氧阈时的氧摄取量(VO_(2)at AT)、峰值氧摄取量(VO_(2)at peak)、无氧阈时的氧脉率(VO_(2)/HR at AT)、峰值氧脉率(VO_(2)/HR at peak)较居家运动康复前升高,差异均有显著性(t=-2.953~-5.483,P<0.05)。两组患者居家运动康复前后无氧阈时的二氧化碳通气效率(VE/VCO_(2)at AT)的差值、峰值二氧化碳通气效率(VE/VCO_(2)at peak)差值比较差异有显著性(Z=-2.046、-2.206,P<0.05)。结论居家运动康复可以改善经皮冠状动脉介入治疗术后急性冠脉综合征患者的心肺功能,且居家运动康复对rSS≥8分的患者心功能获益更显著。
文摘This study explores the predictive value of plasma a disintegrin and metalloproteinase with thrombospondin motifs 5 (ADAMTS-5) levels for major adverse cardiovascular events (MACE) in patients with coronary artery disease (CAD). 595 patients admitted to our hospital were selected. Initially, the serum ADAMTS-5 levels of subjects were analyzed. Subsequently, a receiver operating characteristic (ROC) curve was constructed. Furthermore, the serum levels of ADAMTS-5 were assessed in patients, and based on CAD severity, they were categorized into stable angina pectoris (SAP), unstable angina (UA), non-ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI) groups, with the aim of examining the relationship between ADAMTS-5 levels and CAD severity. Differences in clinical outcomes between patients with high and low levels of ADAMTS-5 were analyzed during the follow-up period. The study found that the serum levels of ADAMTS-5 were significantly higher in the group of patients with coronary artery disease (CAD) compared to the group without CAD, indicating its potential as a diagnostic marker for CAD. The ADAMTS-5 levels in the serum of STEMI patients were higher than those with SAP, while NSTEMI patients showed higher levels of ADAMTS-5 than the UA group. There was a positive correlation between serum ADAMTS-5 levels and the syntax score in CAD patients, suggesting a potential association with adverse clinical outcomes in patients with acute myocardial infarction (AMI). This study indicates that ADAMTS-5 shows promise as a biomarker for CAD and highlights the need for further research and validation.
