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首页> 外文期刊>Circulation journal >Long-term clinical course of patients with isolated myocardial bridge.
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Long-term clinical course of patients with isolated myocardial bridge.

机译：孤立性心肌桥患者的长期临床过程。

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BACKGROUND: Myocardial bridge (MB) is regarded as a common benign lesion on coronary angiography (CAG). It is known to be harmless but may cause several cardiac events and recurrent hospitalization, so in the present study the long-term clinical course of patients with isolated MB and predictors of readmission were investigated. METHODS AND RESULTS: Total 684 patients (343 males, 60.5+/-11.2 years) with persistent chest pain without critical stenosis on CAG were enrolled. The patients were divided into 2 groups according to the presence of MB. Clinical follow-up was performed with respect to readmission after baseline CAG. At a mean follow-up of 37 months, 92 patients (13.3%) were re-admitted because of 79 recurrent chest pain refractory to medication (11.5%), 8 myocardial infarctions (1.2%), 1 life-threatening arrhythmia (0.1%) and 4 deaths (0.6%). There was a significant higher incidence of readmission in the MB group (P=0.038). In multivariate analysis, long MB (hazard ratio (HR) 2.780; 95% confidence interval (CI) 1.070-7.218, P=0.036) and spontaneous vasospasm in CAG (HR 2.335; 95%CI 1.055-5.171, P=0.037) were the predictors of readmission. Moreover, additional use of aspirin or statin decreased the readmission rate. CONCLUSIONS: This study suggests that MB on non-occlusive CAG is not benign and may cause recurrent chest pain, myocardial infarction or life-threatening arrhythmia. Especially, patients with a long MB and vasospasm on CAG need intensive medical therapy, including antiplatelet treatment.
机译：背景：心肌桥（MB）被认为是冠状动脉造影（CAG）上常见的良性病变。众所周知，它无害，但可能会导致一些心脏事件和再次住院，因此，在本研究中，研究了孤立性MB患者和再入预测因子的长期临床过程。方法和结果：总共684例（343例男性，60.5 +/- 11.2岁）持续持续的胸痛，CAG没有严重狭窄。根据MB的存在将患者分为两组。关于基线CAG后再入院的临床随访。平均随访37个月，因79例因药物难治的复发性胸痛（11.5％），8例心肌梗塞（1.2％），1例危及生命的心律失常（0.1％）而重新入院92例（13.3％） ）和4例死亡（0.6％）。 MB组的再入院率显着较高（P = 0.038）。在多变量分析中，CAG中长MB（危险比（HR）2.780; 95％置信区间（CI）1.070-7.218，P = 0.036）和自发性血管痉挛（HR 2.335; 95％CI 1.055-5.171，P = 0.037）重新入院的预测因素。此外，额外使用阿司匹林或他汀类药物可降低再入院率。结论：这项研究表明，非闭塞性CAG的甲基溴不是良性的，并且可能引起反复发作的胸痛，心肌梗塞或危及生命的心律不齐。特别是，在CAG上具有长MB和血管痉挛的患者需要强化药物治疗，包括抗血小板治疗。

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