The impact of cerebral small vessel disease burden on prognosis in patients with acute coronary syndrome  

作　　者：Xiao-Jun DING Yu ZHAO Ze-Ya LI Yong-Bo ZHANG An-Qi YANG Yi HE Rong-Chong HUANG 

机构地区：[1]Department of Cardiology,Beijing Friendship Hospital,Capital Medical University,Beijing,China [2]Department of Neurology,Beijing Friendship Hospital,Capital Medical University,Beijing,China [3]Department of Radiology,Beijing Friendship Hospital,Capital Medical University,Beijing,China

出　　处：《Journal of Geriatric Cardiology》2024年第10期972-980,共9页老年心脏病学杂志（英文版）

基　　金：Supported by the Summit Talent Plan of the Beijing Hospital Management Center(DFL2019-0101);the Leading Talents Plan,Beijing Municipal Health Commission(LJRC20240306).

摘　　要：Background Acute coronary syndrome(ACS)presents with a variable prognosis,posing significant public health challenges.This study investigated the potential link between cerebral small vessel disease(CSVD)burden and outcomes in patients with ACS.Methods In this retrospective cohort study,ACS patients admitted to Beijing Friendship Hospital,Capital Medical Universi-ty,Beijing,China from January 2020 to October 2021,were analyzed.CSVD burden was assessed using magnetic resonance ima-ging markers,including white matter lesions,lacunar infarcts,cerebral microbleeds,and enlarged perivascular spaces.The correl-ation between CSVD burden and clinical outcomes,including major adverse cardiovascular and cerebrovascular events,myocar-dial infarction(MI),target vessel revascularization,stroke,and mortality was examined over a one-year follow-up.Results Out of 248 patients,216 patients were categorized into the low score group(LSG-CSVD)and 32 patients were categor-ized into the high score group(HSG-CSVD).Patients in the HSG-CSVD group exhibited significantly worse prognosis,with an el-evated risk of major adverse cardiovascular and cerebrovascular events,MI,and target vessel revascularization.After adjusting for age,sex,hypertension,troponin T,and estimated glomerular filtration rate,a significantly higher risk of MI was observed in the HSG-CSVD group(HR=4.51,95%CI:1.53-13.26,P=0.006).Subgroup analysis by age and sex consistently demonstrated in-creased adverse outcomes in the HSG-CSVD.Conclusions The study highlights a direct association between increased CSVD burden and poorer ACS outcomes,particular-ly in MI risk.These findings underscore the importance of considering CSVD burden as a crucial prognostic factor in ACS manag-ement,facilitating risk stratification and guiding personalized treatment strategies.

关 键 词：PATIENTS CEREBRAL PROGNOSIS 

分 类 号：R541.4[医药卫生—心血管疾病] R743[医药卫生—内科学]