住院与门诊血糖变异性对冠心病患者冠状动脉斑块易损性的影响

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2022-10-01 DOI:10.1016/j.deman.2022.100104

Kazuya Tateishi, Yuichi Saito, Tatsuro Yamazaki, Hideki Kitahara, Yoshio Kobayashi

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引用次数: 0

摘要

目的尚不清楚住院和门诊血糖变异性(GV)对脂质核心斑块(LCP)的影响。我们评估了住院期间和出院后GV与lcp的关系。方法前瞻性分析35例在近红外光谱血管内超声(NIRS-IVUS)引导下行经皮冠状动脉介入治疗(PCI)治疗急性心肌梗死(MI)和稳定型冠状动脉疾病的患者。采用NIRS-IVUS法测定脂质核心负荷指数(LCBI)和非靶血管4mm内最大LCBI (max LCBI4mm)。用冲洗式血糖监测系统测定GV。结果院内血糖平均偏移幅度(MAGE)明显高于出院后(73.4±26.8 vs 66.0±22.8 mg/dl, p=0.03)。在整个研究人群中，非靶血管LCBI和maxLCBI4mm与出院后MAGE相关(r=0.51, p=0.002和r=0.39, p=0.02)，但与院内MAGE无显著相关。急性心肌梗死患者MAGE与较高LCBI和maxLCBI4mm的关系更为明显。结论PCI患者住院时sgv高于出院后。出院后GV增大与LCBI和maxLCBI4mm升高显著相关，提示动态GV可能与冠状动脉粥样硬化密切相关。

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Impact of in-hospital versus ambulatory glucose variability on coronary plaque vulnerability in patients with coronary artery disease

Aim

The impact of in-hospital and ambulatory glucose variability (GV) on lipid core plaques (LCP) is unclear. We evaluated the relation of GV during hospitalization and after discharge to LCPs.

Methods

A total of 35 patients undergoing percutaneous coronary intervention (PCI) under near-infrared spectroscopy intravascular ultrasound (NIRS-IVUS) guidance for acute myocardial infarction (MI) and stable coronary artery disease were prospectively included. LCP was evaluated with a lipid core burden index (LCBI) and a maximum LCBI in 4 mm (max LCBI_4mm) in the non-target vessel using NIRS-IVUS. GV was measured by a flush glucose monitoring system.

Results

In-hospital mean amplitude of glucose excursion (MAGE) was significantly higher than that after discharge (73.4±26.8 vs. 66.0±22.8 mg/dl, p=0.03). In the entire study population, LCBI and maxLCBI_4mm in the non-target vessel were correlated with MAGE after discharge (r=0.51, p=0.002 and r=0.39, p=0.02), but not significantly correlated with in-hospital MAGE. The relations of MAGE to higher LCBI and maxLCBI_4mm were more evident in patients with acute MI.

Conclusions

GV was greater during hospitalization than after discharge in patients undergoing PCI. Greater GV after discharge was significantly associated with higher LCBI and maxLCBI4_mm, suggesting that ambulatory GV may be closely link to coronary atherosclerosis.

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.