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急性ST段抬高型心肌梗死患者他汀类药物使用与应激性高血糖的关联

Association of statin use and stress-induced hyperglycemia in patients with acute ST-elevation myocardial infarction.

作者信息

Yan Chen, Qin Ma, Juan Yang S, Tao Li Y, Dong Gao M, Zechun Zeng, Chun Yang X, Liang Cong H, Yin Liu, Kang Meng

机构信息

Department of Cardiology, Tianjin Chest Hospital, Tianjin, China.

Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

出版信息

JRSM Cardiovasc Dis. 2016 Apr 21;5:2048004016639442. doi: 10.1177/2048004016639442. eCollection 2016 Jan-Dec.

Abstract

BACKGROUND

Only a few information is available on the risk of stress hyperglycemia following acute myocardial infarction after statin use. We investigate the association of stress-induced hyperglycemia following statin use in patients with acute myocardial infarction.

METHODS

An observational analysis of 476 consecutive patients who suffered acute myocardial infarction was carried out. All selected patients were divided into diabetes mellitus and non-diabetes based on the presence or absence of diabetes. The cardiac incidence of in-hospital and stress-induced hyperglycemia was recorded.

RESULTS

Among patients with stress hyperglycemia in non-diabetes mellitus subgroups, the average fasting plasma glucose values in statin users were higher than in non-statin users (P < 0.05). But in diabetes mellitus subgroups, the average fasting plasma glucose did not have a significant difference between statin users and non-statin users (P > 0.05). In non-diabetes mellitus patients, the incidence of stress hyperglycemia with statin therapy was significantly higher than with non-statin therapy (P = 0.003). But in diabetes mellitus patients group, there is no significant difference in incidence of stress hyperglycemia between patients with statin therapy and patients without statin therapy (P = 0.902).The incidence of heart failure and in-hospital mortality of acute myocardial infarction in patients with stress-induced hyperglycemia was significantly higher than in non-hyperglycemia patients (P < 0.05).

CONCLUSION

Statins are related to higher stress hyperglycemia and cardiac incidences after acute myocardial infarction.

摘要

背景

关于他汀类药物使用后急性心肌梗死后应激性高血糖风险的信息较少。我们调查了他汀类药物使用与急性心肌梗死患者应激性高血糖之间的关联。

方法

对476例连续发生急性心肌梗死的患者进行观察性分析。根据是否患有糖尿病,将所有入选患者分为糖尿病组和非糖尿病组。记录住院期间心脏事件及应激性高血糖的发生率。

结果

在非糖尿病亚组的应激性高血糖患者中,他汀类药物使用者的平均空腹血糖值高于非使用者(P < 0.05)。但在糖尿病亚组中,他汀类药物使用者和非使用者的平均空腹血糖无显著差异(P > 0.05)。在非糖尿病患者中,他汀类药物治疗组的应激性高血糖发生率显著高于非他汀类药物治疗组(P = 0.003)。但在糖尿病患者组中,他汀类药物治疗患者与未接受他汀类药物治疗患者的应激性高血糖发生率无显著差异(P = 0.902)。应激性高血糖患者急性心肌梗死的心力衰竭发生率和住院死亡率显著高于非高血糖患者(P < 0.05)。

结论

他汀类药物与急性心肌梗死后更高的应激性高血糖和心脏事件发生率相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/066f/4844931/fbffbeb866e8/10.1177_2048004016639442-fig1.jpg

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