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Impact of left ventricular hypertrophy on long-term clinical outcomes in hypertensive patients who underwent successful percutaneous coronary intervention with drug-eluting stents

机译:左心室肥大对接受药物洗脱支架成功经皮冠状动脉介入治疗的高血压患者长期临床结局的影响

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摘要

Left ventricular hypertrophy (LVH) is associated with increased risk for vascular events and mortality. This study investigated 8-year clinical outcomes of hypertensive patients with LVH who underwent percutaneous coronary intervention (PCI) with drug-eluting stents (DES) compared with hypertensive patients without LVH.A total of 1704 consecutive hypertensive patients who underwent PCI from 2004 to 2014 were enrolled. We classified them into either the LVH group (n = 406) or the control group (without LVH, n = 1298). LVH was defined by LV mass index > 115 g/m2 in men and > 95 g/m2 in women. After propensity score matched (PSM) analysis, 2 PSM groups (366 pairs, n = 732, c-statistic = 0.629) were generated.For up to 8 years, the LVH group showed a higher incidence of cardiac death (4.4% vs 1.2%, log-rank P = .023, hazard ratio: 3.371, 95% confidence interval: 1.109–10.25; P = .032) compared with the control group. However, there were no significant differences between the 2 groups in the incidence of total death, myocardial infarction, revascularization, and major adverse cardiac events up to 8 years.LVH in hypertensive patients who underwent successful PCI with DES was associated with higher incidence of cardiac death up to 8 years of follow-up. More careful managements and clinical follow-up are needed and treatment strategies should specifically focus to target prevention and reversal of LVH in hypertensive patients.
机译:左心室肥大(LVH)与血管事件和死亡的风险增加相关。这项研究调查了使用LVD的经皮冠状动脉介入治疗(PCI)和药物洗脱支架(DES)的高血压患者与未使用LVH的高血压患者的8年临床结局.2004年至2014年间,共有1704例连续接受PCI的高血压患者被录取了。我们将其分为LVH组(n = 406)或对照组(无LVH,n = 1298)。 LVH的定义是男性的LV质量指数> 115> g / m 2 ,女性的LV质量指数> 95 g / m 2 。倾向得分匹配(PSM)分析后,产生了2个PSM组(366对,n = 732,c-统计= 0.629)。在长达8年的时间里,LVH组的心脏死亡发生率更高(4.4%vs 1.2 %,对数秩P = .023,危险比:3.371,95%置信区间:1.109-10.25; P = .032)。然而,两组之间的总死亡,心肌梗塞,血运重建和严重不良心脏事件的发生率在8年内没有显着差异。接受DES成功PCI的高血压患者的LVH与心脏发生率更高相关死亡长达8年的随访。需要更仔细的管理和临床随访,并且治疗策略应特别集中于针对高血压患者的LVH预防和逆转。

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