2型糖尿病患者的主要不良心血管事件：一项前瞻性研究

IF 2.1 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medicina Clinica Pub Date : 2025-06-20 DOI:10.1016/j.medcli.2025.107028

David Martín-Enguix , Juan Carlos Aguirre Rodríguez , Abraham Hidalgo Rodríguez , María Guisasola Cárdenas , María Sánchez Cambronero , María Nieves Generoso Torres , Manuel Joaquín Castillo , Francisco José Amaro-Gahete

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引用次数: 0

摘要

背景和目的大规模研究（UKPDS和CALIBER）报道，2型糖尿病（T2D）患者的年度主要不良心血管事件（MACE）发生率为2.5-2.6%。然而，西班牙不同地理位置的数据是未知的。本研究的目的是调查生活在西班牙南部的DM2患者中MACE最常见的原因和导致其发生的因素。方法在这项队列研究中，对297例T2D患者进行了49个月的监测，以评估MACE（即卒中、心肌梗死和/或心血管死亡）的发生情况。收集了社会人口学和临床数据（包括心血管疾病危险因素和初始治疗），以检查它们对MACE发生率的影响。结果本组患者平均年龄67.7岁，男性居多（53.3%），平均t2dm病程8.8年。在4年的随访中，10.7%的患者经历了MACE，心肌梗死和心血管死亡是最常见的事件（均为38.7%）。在多变量分析中，T2D每增加一年与MACE风险增加15%相关（HR = 1.150 [1.006-1.314], p = 0.041），而估计肾小球滤过率（eGFR）每增加一个单位与风险降低3.3%相关（HR = 0.967 [0.938-0.997], p = 0.033）。结论心肌梗死和心血管死亡是T2D患者发生MACE的主要原因。较长的T2D持续时间和较低的eGFR是最重要的危险因素。这些发现强调了对长期T2D和/或肾功能受损患者进行更密切监测和强化治疗的必要性。

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Major adverse cardiovascular events among patients with type 2 diabetes mellitus: A prospective study

Background and objectives

Large-scale studies (UKPDS and CALIBER) reported annual major adverse cardiovascular events (MACE) rates of 2.5–2.6% occurrence in patients with type 2 diabetes mellitus (T2D). However, data for different geographical locations in Spain are unknown. The aim of this study was to investigate the most common causes of MACE and the factors that contribute to its occurrence in patients with DM2 living in southern Spain.

Methods

In this cohort study, 297 patients with T2D were monitored over 49 months to assess the occurrence of MACE (i.e., stroke, myocardial infarction, and/or cardiovascular death). Sociodemographic and clinical data (including cardiovascular disease risk factors and initial treatments) were collected to examine their impact on the incidence of MACE.

Results

The mean age of the cohort was 67.7 years, with a male predominance (53.3%) and an average T2D duration of 8.8 years. Over the 4-year follow-up, 10.7% of patients experienced a MACE, with myocardial infarction and cardiovascular death being the most prevalent events (both 38.7%). In multivariate analysis, each additional year of T2D evolution was associated with a 15% increased risk of MACE (HR = 1.150 [1.006–1.314], p = 0.041), while each unit increase in estimated glomerular filtration rate (eGFR) was linked to a 3.3% risk reduction (HR = 0.967 [0.938–0.997], p = 0.033).

Conclusion

Myocardial infarction and cardiovascular death were the leading causes of MACE in T2D patients over a 4-year follow-up. Longer T2D duration and lower eGFR were the most significant risk factors. These findings underscore the need of closer monitoring and intensive treatment in patients with long-standing T2D and/or impaired renal function.

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来源期刊

Medicina Clinica 医学-医学：内科

CiteScore

3.10

自引率

5.10%

发文量

295

审稿时长

22 days

期刊介绍： Medicina Clínica, fundada en 1943, es una publicación quincenal dedicada a la promoción de la investigación y de la práctica clínica entre los especialistas de la medicina interna, así como otras especialidades. Son características fundamentales de esta publicación el rigor científico y metodológico de sus artículos, la actualidad de los temas y, sobre todo, su sentido práctico, buscando siempre que la información sea de la mayor utilidad en la práctica clínica.