应激性高血糖比率对急性心肌梗死后心力衰竭和动脉粥样硬化性心血管事件的影响

IF 3.1 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Shogo Okita, Yuichi Saito, Hiroaki Yaginuma, Kazunari Asada, Hiroki Goto, Osamu Hashimoto, Takanori Sato, Hideki Kitahara, Yoshio Kobayashi
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引用次数: 0

摘要

背景:据报道,急性高血糖状态与急性心血管疾病患者的不良预后有关。虽然应激性高血糖比值(SHR)可用于评估入院时的高血糖状况,但在急性心肌梗死(AMI)中,SHR 与临床预后,尤其是心力衰竭(HF)之间的关系仍不确定:这项回顾性多中心研究纳入了 2386 名接受经皮冠状动脉介入治疗的急性心肌梗死患者。使用血糖和 HbA1c 水平计算 SHR。共同主要终点包括指数住院期间和出院后的心房颤动相关事件(死亡、心房颤动恶化和心房颤动住院)和主要不良心血管事件(MACE;死亡、复发急性心肌梗死和缺血性卒中)。平均(±SD)SHR 为 1.30±0.51;住院期间分别有 680 例(28.5%)和 233 例(9.8%)患者发生心房颤动事件和 MACE。SHR与院内心房颤动事件和MACE独立相关。在中位随访 536 天、存活出院的 2,017 名患者中,分别有 195 人(9.7%)和 214 人(10.6%)发生过房颤事件和 MACE。SHR较高(>1.45)的患者发生心房颤动事件的风险高于SHR≤1.45的患者;两组患者出院后的MACE发生率无显著差异:在急性心肌梗死患者中,SHR可预测院内预后,包括心房颤动事件和MACE,而在出院后,较高的SHR与较高的心房颤动风险相关,但与MACE无关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of the Stress Hyperglycemia Ratio on Heart Failure and Atherosclerotic Cardiovascular Events After Acute Myocardial Infarction.

Background: An acute hyperglycemic status is reportedly associated with poor prognosis in patients with acute cardiovascular diseases. Although the stress hyperglycemia ratio (SHR) is used to evaluate the hyperglycemic condition on admission, relationships between SHR and clinical outcomes, particularly heart failure (HF), remain uncertain in acute myocardial infarction (AMI).

Methods and results: This retrospective multicenter study included 2,386 patients with AMI undergoing percutaneous coronary intervention. SHR was calculated using blood glucose and HbA1c levels. Co-primary endpoints included HF-related events (death, worsening HF, and hospitalization for HF) and major adverse cardiovascular events (MACE; death, recurrent AMI, and ischemic stroke) during the index hospitalization and after discharge. The mean (±SD) SHR was 1.30±0.51; HF events and MACE occurred in 680 (28.5%) and 233 (9.8%) patients during hospitalization, respectively. SHR was independently associated with in-hospital HF events and MACE. Of 2,017 patients who survived to discharge, 195 (9.7%) and 214 (10.6%) experienced HF events and MACE, respectively, over a median follow-up of 536 days. The risk of HF events was higher in patients with a high (>1.45) SHR than in those with SHR ≤1.45; there was no significant difference in MACE rates after discharge between these 2 groups.

Conclusions: In AMI patients, SHR was predictive of in-hospital outcomes, including HF events and MACE, whereas after discharge a higher SHR was associated with higher HF risks, but not MACE.

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来源期刊
Circulation Journal
Circulation Journal 医学-心血管系统
CiteScore
5.80
自引率
12.10%
发文量
471
审稿时长
1.6 months
期刊介绍: Circulation publishes original research manuscripts, review articles, and other content related to cardiovascular health and disease, including observational studies, clinical trials, epidemiology, health services and outcomes studies, and advances in basic and translational research.
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