甘油三酯-葡萄糖指数对并发代谢综合征的急性 ST 段抬高型心肌梗死患者经皮冠状动脉介入治疗后无回流现象的预测价值。

IF 1.7 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
American journal of translational research Pub Date : 2024-10-15 eCollection Date: 2024-01-01 DOI:10.62347/HQVS4428
Zhi Qu, Xiaohua Guan
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引用次数: 0

摘要

目的:急性 ST 段抬高型心肌梗死(STEMI)仍然是全球发病率和死亡率的主要原因。经皮冠状动脉介入治疗(PCI)后出现的无回流现象使 STEMI 的临床结果复杂化。本研究旨在找出预测无回流现象的重要指标:这项回顾性研究分析了 2023 年 1 月至 2023 年 12 月期间接受 PCI 治疗的 378 例 STEMI 患者的临床数据。根据PCI术后冠状动脉造影结果,患者被分为正常回流组(n = 311)和无回流组(n = 67)。收集的数据包括患者的人口统计学特征、用药情况、血脂概况、心脏生物标志物和甘油三酯-葡萄糖(TyG)指数:结果:无回流组患者年龄较大(59.98 ± 3.45 岁 vs. 58.69 ± 3.57 岁,P = 0.007),空腹血糖(118.57 ± 7.23 mg/dL vs. 113.59 ± 7.62 mg/dL,P < 0.001)和甘油三酯(185.36 ± 10.17 mg/dL vs. 176.56 ± 10.38 mg/dL,P < 0.001)较高。无回流组的 TyG 指数明显更高(8.97 ± 1.15 vs. 7.49 ± 1.17,P < 0.001),与无回流的相关性最强(r = 0.420,P < 0.001)。接收者操作特征(ROC)分析表明,TyG 指数是最佳预测指标,阈值为 8.1 时的 AUC 为 0.818。多变量逻辑回归确定 TyG 指数≥ 8.1 是无回流的最强独立预测因子(OR,9.591;95% CI,4.469-20.587,P <0.001)。TyG预测无复流的AUC为0.869,特异性和敏感性分别为0.891和0.791:结论:TyG指数是预测接受PCI治疗的代谢综合征STEMI患者无复流现象的有力指标。其强大的灵敏度和特异性突显了它在风险分层中的作用,使临床医生能够识别高危患者并定制预防策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Predictive value of the triglyceride-glucose index for no-reflow phenomenon after percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction complicated by metabolic syndrome.

Objective: Acute ST-segment elevation myocardial infarction (STEMI) remains a major contributor to morbidity and mortality worldwide. The no-reflow phenomenon following percutaneous coronary intervention (PCI) complicates the clinical outcome of STEMI. This study aimed to identify a valuable predictor for no-reflow phenomenon.

Methods: This retrospective study analyzed clinical data from 378 STEMI patients with metabolic syndrome who underwent PCI between January 2023 and December 2023. Patients were divided into normal reflow (n = 311) and no-reflow (n = 67) groups based on post-PCI coronary angiography results. Data collected included patient demographics, medication usage, lipid profiles, cardiac biomarkers, and the triglyceride-glucose (TyG) index.

Results: Patients in the no-reflow group were older (59.98 ± 3.45 vs. 58.69 ± 3.57 years, P = 0.007), with higher fasting glucose (118.57 ± 7.23 vs. 113.59 ± 7.62 mg/dL, P < 0.001) and triglycerides (185.36 ± 10.17 vs. 176.56 ± 10.38 mg/dL, P < 0.001). The TyG index was notably higher in the no-reflow group (8.97 ± 1.15 vs. 7.49 ± 1.17, P < 0.001), showing the strongest correlation with no-reflow (r = 0.420, P < 0.001). Receiver Operating Characteristic (ROC) analysis identified the TyG index as the best predictor, with an AUC of 0.818 at a threshold of 8.1. Multivariable logistic regression identified TyG index ≥ 8.1 as the strongest independent predictor of no-reflow (OR, 9.591; 95% CI, 4.469-20.587, P < 0.001). The AUC of the TyG for predicting no-reflow was 0.869, with specificity and sensitivity of 0.891 and 0.791, respectively.

Conclusion: The TyG index is a powerful predictor of the no-reflow phenomenon in STEMI patients with metabolic syndrome undergoing PCI. Its robust sensitivity and specificity underscore its utility for risk stratification, enabling clinicians to identify high-risk patients and tailor preventive strategies.

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American journal of translational research
American journal of translational research ONCOLOGY-MEDICINE, RESEARCH & EXPERIMENTAL
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