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代谢综合征患者冠状动脉支架置入术后的血管造影和临床结果。

The angiographic and clinical outcomes after coronary stenting in patients with metabolic syndrome.

机构信息

Department of Gerontology, the first affiliated hospital of Nanjing Medical University, Nanjing 210029, PR China.

出版信息

Atherosclerosis. 2012 Apr;221(2):416-21. doi: 10.1016/j.atherosclerosis.2011.12.016. Epub 2011 Dec 28.

DOI:10.1016/j.atherosclerosis.2011.12.016
PMID:22296884
Abstract

BACKGROUND

Metabolic syndrome (MetS) is regarded as a risk factor for coronary artery disease (CAD). But the influence of MetS on morbidity and mortality after stent implantation in CAD patients remains unknown.

METHODS

This article presents a meta-analysis of available data on the association between the MetS and the risk of angiographic and clinical outcomes following stent implantation.

RESULTS

MetS was associated with a significant increased risk of post-stent all-cause mortality (odd ratio (OR), 2.17, 95% CI, 1.56-3.01), in-lesion restenosis (OR, 1.35, 95% CI, 1.00-1.84) and major adverse cardiac events (MACE) (OR 1.35, 95% CI 1.13-1.61) in CAD patients. Even with drug-eluting stent (DES) implantation, significant increased risk in all-cause mortality (OR, 2.25, 95% CI, 1.61-3.15) and MACE (OR 1.42, 95% CI 1.14-1.76) were remain in patients with MetS. However, the OR of cardiovascular (CV) mortality (1.25, 95% CI 0.71-2.22), MI (1.27, 95% CI 0.87-1.85) and TLR (OR 1.21, 95% CI 0.96-1.53) was not statistically different between the patients with and without metabolic syndrome.

CONCLUSIONS

Metabolic syndrome is an important risk factor in patients with CAD following stent implantation. Although DES implantation decreased the incidence of angiographic events, further progress in adequate treatment of MetS is still required to improve the clinical outcome.

摘要

背景

代谢综合征(MetS)被认为是冠心病(CAD)的危险因素。但是,代谢综合征对 CAD 患者支架植入术后发病率和死亡率的影响尚不清楚。

方法

本文对现有关于代谢综合征与支架植入后血管造影和临床结果风险之间关联的资料进行了荟萃分析。

结果

代谢综合征与支架置入后全因死亡率(比值比(OR),2.17,95%置信区间,1.56-3.01)、病变内再狭窄(OR,1.35,95%置信区间,1.00-1.84)和主要不良心脏事件(MACE)(OR,1.35,95%置信区间,1.13-1.61)显著相关。即使植入药物洗脱支架(DES),代谢综合征患者的全因死亡率(OR,2.25,95%置信区间,1.61-3.15)和 MACE(OR,1.42,95%置信区间,1.14-1.76)仍显著升高。然而,代谢综合征患者的心血管死亡率(OR,1.25,95%置信区间,0.71-2.22)、心肌梗死(OR,1.27,95%置信区间,0.87-1.85)和靶病变血运重建(OR,1.21,95%置信区间,0.96-1.53)的比值无统计学差异。

结论

代谢综合征是 CAD 患者支架植入术后的重要危险因素。尽管 DES 植入降低了血管造影事件的发生率,但仍需进一步加强对代谢综合征的适当治疗,以改善临床结局。

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