合并结缔组织病的冠心病患者冠状动脉病变特点及冠状动脉介入治疗术预后分析

目的探讨合并结缔组织病(CTD)的冠状动脉性心脏病(CAD)患者的冠状动脉病变特点,以及接受经皮冠状动脉介入治疗术(PCI)的长期预后。方法收集106例自2009年1月至2012年12月在北京友谊医院接受PCI治疗CTD患者的临床资料,回顾性分析CTD患者的临床表现和冠状动脉病变特点等,并对CTD患者进行长期随访。结果 106例患者中有92例(86.8%)具有≥1个传统冠心病危险因素。78例(73.6%)的患者冠状动脉为多支血管病变,以前降支受累为主(65.1%)。共植入5枚金属裸支架和202枚药物涂层支架。对CTD患者进行了平均时间长达3年的随访,期间共发生主要不良心血管事件(MACE)24例(22.6%),其中心源性死亡13例(12.3%)、支架内血栓形成(ST)10例(9.4%)、靶血管再次血运重建(TVR)15例(14.2%)。结论合并CTD的CAD患者冠状动脉病变以多支病变为主。此类患者接受PCI术后不良事件以ST及TVR多见。

Features of coronary artery lesions and prognosis after percutaneous coronary intervention in patients with coronary artery disease and connective tissue disease

Objective To investigate the features of coronary artery lesions in the patients suffering from coronary artery disease (CAD) and connective tissue disease (CTD) and their long-term prognosis after percutaneous coronary intervention (PCI). Methods A consecutive series of 106 CTD patients who underwent PCI with stent implantation in our hospital between January 2009 and December 2012 were enrolled in this study. After their medical records were collected, the clinical manifestations and coronary artery lesions features were analyzed retrospectively. They were also followed-up for long-term incidences of major adverse cardiac events (MACE) . Results Ninety-two of the patients (86.8%) had one or more traditional CAD risk factors. Multi-vessel disease was present in the 78(73.6%) patients, with the left anterior descending coronary artery mostly involved (accounting for 65.1%). There were totally 5 bare-metal stents and 202 drug eluting stents implanted. During the follow-up of average 3 years, 24 cases (22.6%) of MACEs were observed, including 13(12.3%) death from cardiac causes, 10(9.4%) of stent thrombosis, and 15(14.2%) of target vessel revascularization (TVR). Conclusion Patients with CTD and CAD are characterized by multi-vessel lesions. Stent thrombosis and TVR are common adverse events in the patients after PCI.