Dab tsi yog Kev Sib Raug Zoo Ntawm CAD thiab CKD
Mar 17, 2023
Mob raum mobthiabkab mob coronary arteryyog co-morbidities nrog tshwj xeeb epidemiological thiab pathophysiological nta uas thaum kawg ua rau ib tug siab tshwm sim ntawm loj mob plawv tshwm sim, nrog rau tag nrho cov-ua rau tuag. Kev tshuaj xyuas los ntawm Gautam R Shroff, Michelle D Carlson, thiab Roy O Mathew qhia txog cov ntsiab lus ntawm cov ntaub ntawv, nrog rau kev soj ntsuam tsis muaj kev pheej hmoo cuam tshuam txog cov neeg no, kev xaiv tshuaj kho mob plawv, thiab cov nuances cuam tshuam nrog coronary revascularization. Kev sib koom tes ntawm pab pawg cardio-lub raum-raws li txoj hauv kev yog qhov tseem ceeb rau kev tswj hwm kev txiav txim siab hauv cov neeg mob no, tshwj xeeb tshaj yog coronary revascularization. Qhov kev tshuaj xyuas no qhia txog cov kev txiav txim siab tshwj xeeb uas cuam tshuam txog coronary revascularization thiab muab cov tswv yim algorithm rau kev xaiv revascularization hauv cov neeg mob uas muaj kab mob raum kawg raws li cov ntaub ntawv muaj.
Nyob rau tib lub sijhawm, cov neeg mob tuaj yeem siv tauCistanche extractlos pab txhim kho lub raum ua haujlwm. Yog li txo qhov tshwm sim thiab zaus ntawm lub raum tsis ua haujlwm.
Mob raum mob (CKD) thiabkab mob plawv(CVD) yog cov xwm txheej uas muaj cov kab mob sib kis sib txawv. Hauv Tebchaws Meskas, ze li 15 feem pua ntawm cov neeg laus raug cuam tshuam los ntawm CKD, thaumkab mob raum kawg(ESKD) cuam tshuam rau cov neeg tsawg dua.
Hauv 2018, nws kwv yees tias kwv yees li 554,038 tus neeg mob tau txais kev lim ntshav thiab 229,887 tus neeg mob tau txais kev hloov pauv raum. Lub nra ntawm CVD yuav luag ob npaug ntawm cov neeg uas muaj CKD piv rau cov uas tsis muaj CKD (66 feem pua vs. 32 feem pua). Ntawm cov neeg mob ESKD ntawm kev lim ntshav, CVD muaj ntau tau kwv yees li ntawm 77 feem pua, nrog cov kab mob plawv (CAD) txog li 44 feem pua. Hauv cov neeg nyob hauv lub tsheb thauj neeg mob ntawm 1.1 lab tus neeg laus, qhov ua rau lub raum ua haujlwm tsis zoo tau pom tias muaj kev sib raug zoo thiab muaj kev ywj pheej nrog txhua qhov ua rau tuag thiab cov xwm txheej CVD.
Ib yam li ntawd, nyob rau hauv kev sib koom ua ke meta-kev soj ntsuam, CKD yog ib qho kev kwv yees ntawm txhua qhov ua rau thiab CVD kev tuag. Qhov kwv yees 2-xyoo hloov kho cov ciaj sia tom qab mob myocardial infarction yog kwv yees li 87 feem pua rau cov neeg uas tsis muaj CKD, 75 feem pua rau cov neeg uas muaj CKD theem 4-5, 53 feem pua rau cov neeg mob ntshav qab zib, thiab 77 feem pua rau cov neeg mob. hloov raum.
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Kev nthuav qhia kho mob thiab cov txiaj ntsig
Cov kev tshawb fawb soj ntsuam tau pom tias cov neeg mob CKD feem ntau tuaj yeem tshwm sim nrog mob hnyav dua li qhov tshwm sim CAD ruaj khov. Qhov tseem ceeb, cov neeg mob uas muaj CKD / ESKD tsis tshua muaj tshwm sim nrog mob hauv siab lossis muaj kev kuaj pom ECG.
Nws kuj tau pom tias qhov kev tuag hauv tsev kho mob ntawm tus mob myocardial infarction nrog CKD yog exponentially siab dua piv rau qhov tsis muaj CKD. Ntau yam ntawm cov laj thawj uas muaj peev xwm ua rau muaj peev xwm tau muab tso ua ke ua qhov muaj feem cuam tshuam. Qhov kev nthuav qhia kev kho mob atypical ntawm AMI tuaj yeem yog qhov muaj peev xwm ua tau zoo, thiab tau muaj pov thawj tsawg dua kev kho mob ntawm cov neeg mob CKD, suav nrog kev kho reperfusion / revascularization. Txawm hais tias nws muaj teeb meem los kos cov lus xaus los ntawm kev soj ntsuam cov ntaub ntawv, muaj kev txhawj xeeb txog kev kho mob nihilism lossis "realism" hauv cov neeg no. Raws li cov ntaub ntawv los ntawm cov kev tshawb fawb niaj hnub no, nws tau lees paub tias AMI kev tuag hauv CKD / ESKD tau poob qis.
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Lub luag haujlwm muaj peev xwm ntawm lub raum Therapeutics
Anemia yog lwm yam teeb meem ntawm CKD. Anemia ua ke nrog CKD yog txuam nrog kev pheej hmoo ntawm kev tuag thiab tsis tuag MI thiab cov txiaj ntsig tsis zoo tom qab PCI. Tsis muaj kev sim tshuaj ntsuam xyuas uas qhia tau tias muaj txiaj ntsig ntawm kev kho cov ntshav ntshav ntawm cov txiaj ntsig kho mob (tag nrho-ua rau kev tuag lossis CV cov xwm txheej) hauv cov tshuaj tsis huv thiab lim ntshav-xav tau cov neeg mob CKD. Cov txiaj ntsig ntawm qhov tshiab hypoxia-inducible factor inhibitors rau kev kho mob ntshav qab zib hauv CKD ntawm cov txiaj ntsig ntawm cov hlab plawv tseem yuav raug txiav txim siab. Thaum kawg, kev kho uremia yuav tsum tau thim rov qab qhov cuam tshuam loj heev ntawm CV system. Txog tam sim no, qhov no yog qhov ua tiav zoo tshaj plaws los ntawm kev hloov lub raum. Kev hloov lub raum muab kev txo qis hauv kev tuag thiab cov xwm txheej hauv plawv piv rau kev lim ntshav txuas ntxiv.
Cov neeg mob nrog CKD / ESKD ua ke nrog CAD yog cov neeg muaj kev pheej hmoo siab nrog cov kab mob sib kis tshwj xeeb thiab cov kab mob pathophysiologic thiab nuances hauv kev ntsuam xyuas tsis muaj kev pheej hmoo, tshuaj kho mob, thiab kev kho mob plawv. Kev sib koom tes hauv pab pawg cardio-lub raum yog qhov tseem ceeb rau kev tswj hwm kev txiav txim siab tseem ceeb hauv cov neeg mob no, tshwj xeeb tshaj yog thaum ua kev kho mob coronary revascularization.
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REFERENCES
1. Teb Chaws Asmeskas lub raum Data System. USRDS Daim Ntawv Qhia Txhua Xyoo: Kev Kab Mob Kab Mob raum hauv Tebchaws Meskas. Bethesda, MD: National Institutes of Health, National Institute of Diabetes thiab Digestive thiab raum Kab Mob, 2020.
2. Saran R, Robinson B, Abbott KC, et al. US Renal Data System 2016 Daim Ntawv Qhia Txhua Xyoo: Kev kis kab mob raum hauv Tebchaws Meskas. Am J Raum Dis 2017;69(3 Suppl 1):A7–8.
3. Go AS, Chertow GM, Fan D, et al. Cov kab mob hauv lub raum ntev thiab kev pheej hmoo ntawm kev tuag, kab mob plawv, thiab pw hauv tsev kho mob. N Engl J Med 2004; 351: 1296–305.
4. Matsushita K, van der Velde M, Astor BC, et al. Lub koom haum ntawm kwv yees glomerular filtration rate thiab albuminuria nrog tag nrho cov ua rau thiab cov hlab plawv tuag nyob rau hauv cov pej xeem cohorts: ib tug sib koom meta-kev tshuaj ntsuam. Lancet 2010; 375:2073–81.
5. Go AS, Bansal N, Chandra M, et al. Mob raum mob thiab muaj feem yuav tshwm sim nrog mob myocardial infarction piv rau qhov ruaj khov angina hauv cov neeg laus uas muaj kab mob plawv. J Am Coll Cardiol 2011; 58:1600–7.
6. Shroff GR, Frederick PD, Herzog CA. Lub raum tsis ua hauj lwm thiab mob myocardial infarction: cov yam ntxwv kho mob hauv cov neeg mob uas muaj kab mob raum mob hnyav, ntawm kev lim ntshav, thiab tsis muaj kab mob raum ntev. Ib txoj haujlwm sib koom tes ntawm Tebchaws Meskas Lub Raum Cov Ntaub Ntawv / Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv Hauv Tebchaws thiab National Registry of Myocardial Infarction. Am Heart J Mar 2012; 163:399–406.
7. Lee MG, Jeong MH, Lee KH, et al. Kev sib piv ntawm cov kab mob hauv lub raum ntev thiab muaj feem yuav tshwm sim nrog qhov mob tsis zoo piv rau qhov tsis mob tsis mob myocardial infarction. Am J Cardiol 2012; 110:790–4.
8. Herzog CA, Littrell K, Arko C, et al. Cov yam ntxwv ntawm kev lim ntshav cov neeg mob uas mob myocardial infarction hauv Tebchaws Meskas: kev sib koom tes ntawm Tebchaws Meskas Lub Raum Cov Ntaub Ntawv thiab National Registry of Myocardial Infarction. Ntawv Moo Zoo 2007; 11:1465–72.
9. Fox CS, Muntner P, Chen AY, et al. Kev siv cov pov thawj-raws li kev kho mob nyob rau lub sij hawm luv luv ntawm ST-segment nce myocardial infarction thiab non-ST-segment elevation myocardial infarction hauv cov neeg mob mob raum: ib daim ntawv qhia los ntawm National Cardiovascular Data Acute Coronary Treatment and Intervention Outcomes Network registry. Ntawv Moo Zoo 2010; 121:357–65.
10. Szummer K, Lundman P, Jacobson SH, et al. Kev sib raug zoo ntawm lub raum kev ua haujlwm, kev nthuav qhia, kev siv cov kev kho mob thiab cov teeb meem hauv tsev kho mob hauv cov mob coronary: cov ntaub ntawv los ntawm SWEDEHEART sau npe. J Intern Med 2010; 268:40–9.
11. Shroff GR, Li S, Herzog CA. Cov xwm txheej hauv kev tuag tom qab mob myocardial infarction ntawm cov neeg mob lim ntshav hauv Tebchaws Meskas tshaj li 15 xyoo. J Am Heart Assoc 2015; 4:e002460.
12. Bagai A, Lu D, Lucas J, et al. Ib ntus tiam sis hauv kev siv cov kev kho mob plawv thiab cov txiaj ntsig tau rau myocardial infarction los ntawm qib ntawm cov kab mob raum ntev: ib daim ntawv qhia los ntawm NCDR Chest Pain-MI npe. J Am Heart Assoc 2018;7:e010394.
13. Goodman WG, Goldin J, Kuizon BD, et al. Coronary-artery calcification nyob rau hauv cov tub ntxhais hluas uas muaj cov kab mob hauv lub raum kawg uas tab tom lim ntshav. N Engl J Med May 2000; 342:1478–83.
14. Bleyer AJ, Burkart J, Piazza M, et al. Kev hloov pauv hauv plawv plawv tom qab parathyroidectomy hauv cov neeg mob ESRD. Am J Kidney Dis 2005; 46:464–9.
15. Chertow GM, Block GA, Correa-Rotter R, et al. Cov txiaj ntsig ntawm cinacalcet rau cov kab mob plawv hauv cov neeg mob uas tau lim ntshav. N Engl J Med 2012; 367:2482–94.
16. Wheeler DC, London GM, Parfrey PS, et al. Cov teebmeem ntawm cinacalcet ntawm atherosclerotic thiab nonatherosclerotic cardiovascular cov xwm txheej hauv cov neeg mob tau txais hemodialysis: EValuation Of Cinacalcet HCl Therapy to Lower CardioVascular Events (EVOLVE) trial. J Am Heart Assoc 2014; 3:e001363.
17. Habbous S, Przech S, Acedillo R, et al. Kev ua tau zoo thiab kev nyab xeeb ntawm sevelamer thiab lanthanum tiv thaiv cov calcium uas muaj thiab hlau-raws li cov ntaub ntawv hauv kev kho mob hyperphosphatemia hauv cov neeg mob uas muaj kab mob hauv lub raum: kev tshuaj xyuas thiab tshuaj xyuas meta. Nephrol Dial Hloov 2017; 32: 111–25.
18. Patel L, Bernard LM, Txwj Laug GJ. Sevelamer piv rau calcium-raws li binders rau kev kho mob ntawm hyperphosphatemia hauv CKD: ib qho kev tshuaj ntsuam meta-kev soj ntsuam ntawm randomized tswj kev sim. Clin J Am Soc Nephrol 2016; 11:232–44.
