Association between coronary artery stenosis and myocardial injury in patients with acute pulmonary embolism:A case-control studyOACSTPCDMEDLINE
Association between coronary artery stenosis and myocardial injury in patients with acute pulmonary embolism:A case-control study
Background:The potential impact of pre-existing coronary artery stenosis(CAS)on acute pulmonary embolism(PE)episodes remains underexplored.This study aimed to investigate the association between pre-existing CAS and the elevation of high-sensi-tivity cardiac troponin Ⅰ(hs-cTnⅠ)levels in patients with PE. Methods:In this multicenter,prospective case-control study,88 cases and 163 controls matched for age,sex,and study center were enrolled.Cases were patients with PE with elevated hs-cTnⅠ.Controls were patients with PE with normal hs-cTnⅠ.Coronary artery assessment utilized coronary computed tomographic angiography or invasive coronary angiography.CAS was defined as≥50％stenosis of the lumen diameter in any coronary vessel＞2.0 mm in diameter.Conditional logistic regression was used to evaluate the association between CAS and hs-cTnⅠ elevation. Results:The percentage of CAS was higher in the case group compared to the control group(44.3％[39/88]vs.30.1％[49/163];P=0.024).In multivariable conditional logistic regression model 1,CAS(adjusted odds ratio[OR],2.680;95％confidence interval[CI],1.243-5.779),heart rate＞75 beats/min(OR,2.306;95％CI,1.056-5.036)and N-terminal pro-B type natriuretic peptide(NT-proBNP)＞420 pg/mL(OR,12.169;95％CI,4.792-30.900)were independently associated with elevated hs-cTnI.In model 2,right CAS(OR,3.615;95％CI,1.467-8.909)and NT-proBNP＞420 pg/mL(OR,13.890;95％CI,5.288-36.484)were independently associated with elevated hs-cTnⅠ. Conclusions:CAS was independently associated with myocardial injury in patients with PE.Vigilance towards CAS is warranted in patients with PE with elevated cardiac troponin levels.
Yinjian Yang;Liting Wang;Sijin Zhang;Xianmei Li;Bingxiang Wu;Kai Sun;Yimin Mao;Xiqi Xu;Tianyu Lian;Chunyan Cheng;Zhicheng Jing;Chao Liu;Jieling Ma;Xijie Zhu;Jingsi Ma;Dan Lu;Xinxin Yan;Xuan Gao;Jia Wang
Medical Science Research Center,Institute of Clinical Medicine,State Key Laboratory of Complex Severe and Rare Diseases,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,ChinaDepartment of Cardiology,Guangdong Cardiovascular Institute,Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou,Guangdong 510080,ChinaDepartment of Cardiology,State Key Laboratory of Complex Severe and Rare Diseases,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,ChinaDepartment of Cardiovascular Medicine,The Second Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang 150001,ChinaDepartment of Respiratory Medicine,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang,Henan 471003,ChinaCenter of Basic Medical Research,Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou,Guangdong 510080,ChinaDepartment of School of Pharmacy,Henan University,Kaifeng,Henan 475001,ChinaCardiac Department,Aerospace Center Hospital,Peking University Aerospace School of Clinical Medicine,Beijing 100049,ChinaDepartment of Cardiology,State Key Laboratory of Cardiovascular Disease,National Center for Cardiovascular Diseases,Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100037,ChinaDepartment of Medical Laboratory,Weifang Medical University,Weifang,Shandong 261053,China
Pulmonary embolismCoronary artery stenosisMyocardial injuryCardiac troponin ⅠMyocardial ischemiaRight ventricular dysfunctionCase-control studyCoronary computed tomography angiography
《中华医学杂志（英文版）》 2024 (016)
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The study was supported by grants from the National Key Research and Development Program of China(No.2022YFC2703902),the National High Level Hospital Clinical Research Funding(No.2022-PUMCH-B-099),and the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(Nos.2020-I2M-C&T-B-003,and 2021-I2M-1-018).
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