Yang Xishan, Liu Hui, Yang Fangfang, Dong Pingshuan, Fa Xianen, Zhang Qingyong, Li Li, Wang Zhikuan, Zhao Di
Division of Cardiology, the First Hospital Affiliated to Henan Science and Technology University, China.
Intern Med. 2015;54(5):439-44. doi: 10.2169/internalmedicine.54.3295. Epub 2015 Jan 15.
This study was designed to determine the SYNTAX score under different fasting plasma glucose (FPG) states in Chinese patients undergoing coronary angiography, particularly subjects with impaired FPG.
Four hundred and forty-six subjects undergoing coronary angiography were enrolled in this study and divided into four groups based on the FPG level or a history of type 2 diabetes mellitus (T2DM): normal FPG, impaired FPG, known and previously unknown T2DM.
The angiographic SYNTAX scores were higher in the subjects with known (p<0.001) or previously unknown (p<0.001) T2DM than in those with normal FPG. There were significant differences in the number of diseased coronary artery vessels between the subjects with known (p<0.01) or unknown T2DM (p<0.05) and the subjects with normal FPG. However, there were no significant differences in the SYNTAX score or the number of diseased coronary artery vessels between the subjects with impaired FPG and those with normal FPG. The subjects with impaired FPG (2.917-fold, p=0.004) and known (3.064-fold, p=0.000) or previously unknown (3.301-fold, p=0.000) T2DM exhibited a significantly elevated risk of having an intermediate or high SYNTAX score compared with the subjects with normal FPG.
Chinese subjects with impaired FPG have a significantly elevated risk of having an intermediate or high SYNTAX score, indicating a risk of severe coronary artery lesions. Subjects with known or previously unknown T2DM may have severe coronary artery lesions. These findings suggest the importance of achieving better glycemic control in order to prevent coronary atherosclerosis and improve the cardiovascular prognosis.
本研究旨在确定接受冠状动脉造影的中国患者在不同空腹血糖(FPG)状态下的SYNTAX评分,尤其是空腹血糖受损的受试者。
本研究纳入了446例接受冠状动脉造影的受试者,并根据FPG水平或2型糖尿病(T2DM)病史分为四组:空腹血糖正常、空腹血糖受损、已知和既往未知的T2DM。
已知(p<0.001)或既往未知(p<0.001)T2DM的受试者的血管造影SYNTAX评分高于空腹血糖正常的受试者。已知(p<0.01)或未知T2DM(p<0.05)的受试者与空腹血糖正常的受试者之间,病变冠状动脉血管数量存在显著差异。然而,空腹血糖受损的受试者与空腹血糖正常的受试者之间,SYNTAX评分或病变冠状动脉血管数量没有显著差异。与空腹血糖正常的受试者相比,空腹血糖受损(2.917倍,p=0.004)以及已知(3.064倍,p=0.000)或既往未知(3.301倍,p=0.000)T2DM的受试者出现中等或高SYNTAX评分的风险显著升高。
空腹血糖受损的中国受试者出现中等或高SYNTAX评分的风险显著升高,表明存在严重冠状动脉病变的风险。已知或既往未知T2DM的受试者可能存在严重冠状动脉病变。这些发现提示了更好地控制血糖以预防冠状动脉粥样硬化和改善心血管预后的重要性。