急性冠脉综合征患者30天随访期间血糖变异性与主要不良心血管和脑血管事件（MACCE）之间的关联。
Association between glycemic variability and major adverse cardiovascular and cerebrovascular events (MACCE) in patients with acute coronary syndrome during 30-day follow-up.
作者信息
Xia Jinggang, Xu Ji, Li Boyu, Liu Zhi, Hao Hengjian, Yin Chunlin, Xu Dong
机构信息
Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China..
出版信息
Clin Chim Acta. 2017 Mar;466:162-166. doi: 10.1016/j.cca.2017.01.022. Epub 2017 Jan 19.
BACKGROUND
We explored the association between glycemic variability and major adverse cardiovascular and cerebrovascular events (MACCE) in patients with acute coronary syndrome (ACS) during 30-day follow-up.
METHODS
From May 2013 to April 2015, a total of 864 patients with ACS were divided to high glycemic variability group (H group) (n=285) and low glycemic variability group (L group) (n=579). The primary end point was a 30-day incidence of MACCE. Secondary end points were the incidence of atrial fibrillation (AF) during hospitalization and length of hospital stay.
RESULTS
The primary end point occurred in 15.2% of patients in H group and in 9.7% in L group (p=0.03). The incidence of AF during hospitalization was 14.5% in H group and 8.9% in L group (p=0.02). Compared with the L group, the H group extended the length of hospital stay. Multivariable analysis suggested that high glycemic variability conferred a 57% risk increment of 30-day MACCE (odds ratio 1.97, 95% confidence interval 1.32-6.86; p=0.02).
CONCLUSION
The trial shows that higher blood glucose variability was correlated with higher incidence of MACCE, AF and longer length of stay.
背景
我们探讨了急性冠脉综合征（ACS）患者在30天随访期间血糖变异性与主要不良心血管和脑血管事件（MACCE）之间的关联。
方法
2013年5月至2015年4月，共864例ACS患者被分为高血糖变异性组（H组）（n = 285）和低血糖变异性组（L组）（n = 579）。主要终点是MACCE的30天发生率。次要终点是住院期间房颤（AF）的发生率和住院时间。
结果
H组15.2%的患者出现主要终点，L组为9.7%（p = 0.03）。H组住院期间AF的发生率为14.5%，L组为8.9%（p = 0.02）。与L组相比，H组延长了住院时间。多变量分析表明，高血糖变异性使30天MACCE的风险增加57%（优势比1.97，95%置信区间1.32 - 6.86；p = 0.02）。
结论
该试验表明，较高的血糖变异性与较高的MACCE发生率、AF发生率和更长的住院时间相关。
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