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糖尿病对接受颈动脉支架置入术患者预后的影响:来自单中心注册研究的见解

Impact of diabetes mellitus on outcome of patients undergoing carotid artery stenting: insights from a single center registry.

作者信息

Gurm Hitinder S, Rajagopal Vivek, Sachar Ravish, Abou-Chebl Alex, Kapadia Samir R, Bajzer Chris, Yadav Jay S

机构信息

Cleveland Clinic Foundation, Cleveland, OH, USA.

出版信息

Catheter Cardiovasc Interv. 2007 Mar 1;69(4):541-5. doi: 10.1002/ccd.21020.

Abstract

OBJECTIVE

To evaluate the impact of diabetic status on outcome of patients undergoing carotid artery stenting (CAS).

BACKGROUND

Diabetes has been demonstrated to be a strong predictor of adverse outcome in patients undergoing coronary revascularization. Its significance in predicting outcome of patients undergoing carotid interventions has not been ascertained.

METHODS

We evaluated the short-term outcomes of 833 patients who underwent CAS at our institution. The primary outcome of this analysis was 30 day incidence of stroke, myocardial infarction, and death.

RESULTS

Diabetes was present in 311 patients. Baseline characteristics were comparable between diabetics and nondiabetics except for the diabetics having a lower left ventricular ejection fraction, lower hemoglobin, and a higher body mass index at baseline. Further, they were more likely to have congestive heart failure and coronary artery disease. There was no difference in the incidence of stroke (1.9% versus 2.7%,), myocardial infarction (MI) (2.6% versus 1.9%), death (3.9% versus 2.5%), or the composite of death stroke or MI (6.8% versus 5.9%) at 30 days between diabetics and nondiabetics. Similar results were seen when the analysis was restricted to patients treated with an emboli protection device. Diabetes was not a risk factor for adverse outcome after CAS after multivariate adjustment.

CONCLUSION

Diabetics undergoing CAS are more likely to have associated co-morbidities. However despite this handicap, their short term outcome after CAS is similar to that of nondiabetics.

摘要

目的

评估糖尿病状态对接受颈动脉支架置入术(CAS)患者预后的影响。

背景

糖尿病已被证明是接受冠状动脉血运重建患者不良预后的有力预测指标。其在预测接受颈动脉介入治疗患者预后中的意义尚未确定。

方法

我们评估了在我院接受CAS的833例患者的短期预后。该分析的主要结局是30天内发生卒中、心肌梗死和死亡的情况。

结果

311例患者患有糖尿病。糖尿病患者和非糖尿病患者的基线特征具有可比性,只是糖尿病患者在基线时左心室射血分数较低、血红蛋白较低且体重指数较高。此外,他们更有可能患有充血性心力衰竭和冠状动脉疾病。糖尿病患者和非糖尿病患者在30天时的卒中发生率(1.9%对2.7%)、心肌梗死(MI)发生率(2.6%对1.9%)、死亡率(3.9%对2.5%)或死亡、卒中和MI的复合发生率(6.8%对5.9%)没有差异。当分析仅限于使用栓子保护装置治疗的患者时,也观察到了类似结果。多变量调整后,糖尿病不是CAS后不良预后的危险因素。

结论

接受CAS的糖尿病患者更有可能伴有合并症。然而,尽管有这种不利因素,他们CAS后的短期预后与非糖尿病患者相似。

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