【摘要】 目的:分析高血压史与急性冠脉综合征(ACS)患者远期冠脉不良预后的关系。方法:本研究为回顾性单中心观察性研究。连续收集2013年1月至2014年2月在西安交通大学第一附属医院心血管内科住院，临床确诊的ACS并接受冠状动脉造影(CAG)检查的患者385例作为研究对象。缺血事件定义为再次血运重建、支架内血栓、支架内再狭窄和活动性心绞痛。采用Kaplan-Meier生存曲线和Cox回归分析来研究高血压史与ACS患者远期冠脉不良预后的关系。结果:根据高血压史的中位数，385例患者被分为高血压史≤1年组(201例)和高血压史>1年组(184例)。在随访2.6(2.3, 2.8)年后，高血压史≤1年组和高血压史>1年组分别有39例(19.4%)、46例(25.0%)发生了缺血事件。Kaplan-Meier生存曲线分析提示高血压史>1年组的缺血事件发生率显著高于高血压史≤1年组(χ~2=4.675,P=0.031)。在调整了可能的混杂因素后，多元Cox回归分析提示高血压史仍是ACS患者缺血事件的独立危险因素(HR=1.033,95%CI 1.008-1.057,P=0.008)。结论:高血压史是急性冠脉综合征患者发生远期缺血事件的独立危险因素；并且随着高血压史时间延长，发生缺血事件的风险显著增加。更多还原

【Abstract】 Objective: To analyze the relationship between hypertension history and long-term coronary adverse prognosis in patients with acute coronary syndrome(ACS).Methods: The study was a retrospective, single-center, observational research.A total of 385 patients, who admitted in Department of Cardiology of First Affiliated Hospital of Xi’an Jiaotong University from January 2013 to February 2014, diagnosed as ACS and received coronary angiography(CAG), were continuously collected.Ischemic events were defined as revascularization, in-stent thrombosis, in-stent restenosis and active angina.Kaplan-Meier survival curve and Cox regression analysis were used to determine the relationship between hypertension history and long-term coronary adverse prognosis in ACS patients.Results:The 385 patients were divided into hypertension history ≤1 year group(n=201) and hypertension history >1 year group(n=184) according to the median of hypertension history.After follow-up of 2.6(2.3, 2.8) years, 39 cases(19.4%) and 46 cases(25.0%) suffered from ischemic events in hypertension history ≤1 year group and hypertension history >1 year group respectively.Kaplan-Meier survival curve analysis revealed that the incidence rate of ischemic events in hypertension history >1 year group was significantly higher than that of hypertension history ≤1 year group(χ~2=4.675, P=0.031).After adjusting possible confounding factors, multivariable Cox regression analysis indicated that hypertension history remained an independent risk factor of ischemic events in ACS patients(HR=1.033, 95%CI 1.008-1.057, P=0.008).Conclusion: Hypertension history is an independent risk factor for long-term ischemic events in patients with acute coronary syndrome.And the risk of ischemic events is significantly increasing with the longer hypertension history.更多还原