Won Ki-Bum, Kim Byeong-Keuk, Chang Hyuk-Jae, Shin Dong-Ho, Kim Jung-Sun, Ko Young-Guk, Choi Donghoon, Ha Jong-Won, Hong Myeong-Ki, Jang Yangsoo
Department of Cardiology, Myongji Hospital Cardiovascular Center, Goyang, Republic of Korea.
Catheter Cardiovasc Interv. 2014 Apr 1;83(5):713-20. doi: 10.1002/ccd.25150. Epub 2013 Nov 15.
This study aimed to evaluate long-term survival according to the presence of metabolic syndrome (MS) in patients with acute myocardial infarction (AMI) undergoing successful percutaneous coronary intervention (PCI) with drug-eluting stents (DES).
Despite the significance of coronary reperfusion in AMI, the prognostic impact of MS has been investigated under inconsistent reperfusion therapy in AMI patients.
Three-year clinical outcomes, including all-cause death and the composite of cardiac death or myocardial infarction, were evaluated according to MS status for 963 patients with AMI treated with successful PCI with DES. This study included 494 subjects with MS (51%) and 469 subjects without MS (49%). The incidence of multivessel disease and the mean number of implanted stents were significantly higher in patients with MS than in patients with non-MS. The occurrence of all-cause death (5.9% vs. 6.4%, P = 0.789) and the composite outcomes (5.1% vs. 6.2%, P = 0.485) did not differ significantly between patients with and without MS. Cox regression models revealed that MS had no significant impact on all-cause death (hazard ratio [HR] 0.91; 95% confidence interval [CI] 0.55-1.52; P = 0.726) or the composite outcomes (HR 0.81; 95% CI 0.48-1.39; P = 0.448). Obesity was associated with a decreased risk of all-cause death and the composite outcomes among all MS components.
No difference was observed in long-term survival according to the presence of MS in patients with AMI after successful PCI with DES. This suggests that reperfusion therapy using PCI with DES is equally beneficial in patients AMI with and without MS.
本研究旨在评估接受药物洗脱支架(DES)成功经皮冠状动脉介入治疗(PCI)的急性心肌梗死(AMI)患者中,根据代谢综合征(MS)的存在情况的长期生存率。
尽管冠状动脉再灌注在AMI中具有重要意义,但在AMI患者不一致的再灌注治疗下,MS的预后影响已得到研究。
对963例接受DES成功PCI治疗的AMI患者,根据MS状态评估三年临床结局,包括全因死亡以及心源性死亡或心肌梗死的复合结局。本研究纳入494例有MS的受试者(51%)和469例无MS的受试者(49%)。MS患者多支血管病变的发生率和植入支架的平均数量显著高于无MS患者。有MS和无MS患者的全因死亡发生率(5.9%对6.4%,P = 0.789)和复合结局发生率(5.1%对6.2%,P = 0.485)无显著差异。Cox回归模型显示,MS对全因死亡(风险比[HR] 0.91;95%置信区间[CI] 0.55 - 1.52;P = 0.726)或复合结局(HR 0.81;95% CI 0.48 - 1.39;P = 0.448)无显著影响。在所有MS组分中,肥胖与全因死亡和复合结局风险降低相关。
在接受DES成功PCI治疗的AMI患者中,根据MS的存在情况,长期生存率未观察到差异。这表明使用DES的PCI再灌注治疗对有和无MS的AMI患者同样有益。