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糖尿病对中国患者经皮冠状动脉介入治疗的影响:一项大型单中心数据

Impact of Diabetes Mellitus on Percutaneous Coronary Intervention in Chinese Patients: A Large Single-Center Data.

作者信息

Wang Huanhuan, Gao Zhan, Song Ying, Tang Xiaofang, Xu Jingjing, Jiang Ping, Jiang Lin, Chen Jue, Gao Lijian, Song Lei, Zhang Yin, Zhao Xueyan, Qiao Shubin, Yang Yuejin, Gao Runlin, Xu Bo, Yuan Jinqing

机构信息

1 Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.

出版信息

Angiology. 2018 Jul;69(6):540-547. doi: 10.1177/0003319717735226. Epub 2017 Oct 26.

Abstract

AIM

To investigate the impact of diabetic status on 2-year clinical outcomes in Chinese patients undergoing contemporary percutaneous coronary intervention (PCI) treatment.

METHODS AND RESULTS

A total of 10 724 consecutive patients underwent PCI at Fu Wai Hospital were prospectively collected. Two-year clinical outcomes were compared between patients with and without diabetes mellitus (DM). Diabetic patients had more baseline clinical risks and more extensive coronary disease. During 2-year follow-up, the rates of all-cause death, myocardial infarction (MI), revascularization, and major adverse cardiac events (MACE) were significantly higher in DM group. After multivariable-adjusted Cox regression analysis, DM was an independent risk factor for MACE but not for the individual components of MACE. After performing propensity score matching, rates of all-cause death, MI, revascularization, stroke, stent thrombosis, and MACE were not significantly different between the 2 groups, and DM was not predictive of MACE and any clinical adverse outcomes.

CONCLUSIONS

Diabetic patients who underwent PCI had worse prognosis including death and repeat revascularization during 2-year follow-up, but DM was not an independent risk factor for adverse clinical outcomes.

摘要

目的

探讨糖尿病状态对接受当代经皮冠状动脉介入治疗(PCI)的中国患者2年临床结局的影响。

方法与结果

前瞻性收集了在阜外医院连续接受PCI治疗的10724例患者。比较了糖尿病患者与非糖尿病患者的2年临床结局。糖尿病患者具有更多的基线临床风险和更广泛的冠状动脉疾病。在2年随访期间,糖尿病组的全因死亡、心肌梗死(MI)、血运重建和主要不良心脏事件(MACE)发生率显著更高。经过多变量调整的Cox回归分析后,糖尿病是MACE的独立危险因素,但不是MACE各个组成部分的独立危险因素。进行倾向评分匹配后,两组之间的全因死亡、MI、血运重建、卒中、支架血栓形成和MACE发生率无显著差异,糖尿病不能预测MACE和任何临床不良结局。

结论

接受PCI治疗的糖尿病患者在2年随访期间预后较差,包括死亡和再次血运重建,但糖尿病不是不良临床结局的独立危险因素。

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