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[代谢综合征及其各组分对接受经皮冠状动脉介入治疗患者长期预后的影响]

[The impact of metabolic syndrome and its individual components on long-term prognosis of patients undergoing percutaneous coronary intervention].

作者信息

Wang H H, Jia S D, Liu Y, Xu J J, Gao Z, Song Y, Tang X F, Jiang P, Zhao X Y, Song L, Zhang Y, Chen J, Yang Y J, Gao R L, Qiao S B, Xu B, Yuan J Q, Gao L J

机构信息

Department of Cardiology, Fuwai Hospital and Cardiovascular Institute, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2020 Jun 2;100(21):1623-1628. doi: 10.3760/cma.j.cn112137-20190920-02077.

Abstract

To investigate the impact of metabolic syndrome (MS) and its individual components on long-term prognosis of patients undergoing percutaneous coronary intervention(PCI). Patients who underwent PCI in Fuwai Hospital in 2013 were enrolled and divided to two groups: with MS and without MS. The primary endpoint of 2-year follow-up was major adverse cardiovascular events (MACE), including death, myocardial infarction, and repeat revascularization. Of the 10 422 PCI patients, there were 5 656 (54.27%) without MS and 4 766 (45.73%) with MS. Patients in the MS group were younger, tended to be male and had more comorbidities. There were no significant differences between the two groups in the proportion of drug-coated stents and the success rate of interventional therapy. The 2-year follow-up showed that the incidence of MACE in the MS group was significantly higher than that in the MS-free group (12.0% vs 10.0%, 0.001), which was mainly due to the significantly higher revascularization rate in the MS group than in the non-MS group (9.5% vs 7.9%, 0.003). Cox's regression analysis showed that MS was an independent risk factor for MACE. In MS component analysis, abnormal glucose metabolism was an independent risk factor for MACE events. Among the patients undergoing PCI, the incidence of MACE in patients with MS is significantly higher than that in patients without MS, and MS was an independent risk factor for MACE. In addition, hyperglycemia is an independent predictor for MACE.

摘要

为探讨代谢综合征(MS)及其各组分对接受经皮冠状动脉介入治疗(PCI)患者长期预后的影响。选取2013年在阜外医院接受PCI治疗的患者,分为两组:有MS组和无MS组。2年随访的主要终点是主要不良心血管事件(MACE),包括死亡、心肌梗死和再次血运重建。在10422例PCI患者中,无MS者5656例(54.27%),有MS者4766例(45.73%)。MS组患者较年轻,男性居多,合并症更多。两组在药物涂层支架比例和介入治疗成功率方面无显著差异。2年随访显示,MS组MACE发生率显著高于无MS组(12.0%对10.0%,P<0.001),这主要是由于MS组血运重建率显著高于非MS组(9.5%对7.9%,P=0.003)。Cox回归分析显示,MS是MACE的独立危险因素。在MS组分分析中,糖代谢异常是MACE事件的独立危险因素。在接受PCI治疗的患者中,有MS患者的MACE发生率显著高于无MS患者,且MS是MACE的独立危险因素。此外,高血糖是MACE的独立预测因素。

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