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营养指数对老年冠心病患者长期结局的影响:SHINANO5 年注册研究的亚组分析。

Impact of nutritional index on long-term outcomes of elderly patients with coronary artery disease: sub-analysis of the SHINANO 5 year registry.

机构信息

Department of Cardiovascular Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.

Department of Cardiology, Nagano Municipal Hospital, Nagano, Japan.

出版信息

Heart Vessels. 2021 Jan;36(1):7-13. doi: 10.1007/s00380-020-01659-0. Epub 2020 Jun 30.

DOI:10.1007/s00380-020-01659-0
PMID:32607637
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7788017/
Abstract

Nutritional status is a novel approach to prognostic assessment in patients with cardiovascular disease. However, assessment of nutritional status in elderly patients is challenging due to the significant differences between young patients. The TCBI (Triglycerides × Total cholesterol × Body Weight Index) is a novel and simple nutritional index for predicting long-term outcomes in patients with coronary artery disease. This retrospective study evaluated the efficacy of TCBI in 597 elderly (≥ 75 years) patients enrolled in the SHINANO 5 year registry. The SHINANO 5 year registry, a prospective observational multicenter cohort study, had enrolled 1501 consecutive patients who underwent elective/urgent percutaneous coronary intervention (PCI). In this study, patients were categorized into TCBI quartile groups. The primary endpoints were the occurrence of major adverse cardiac and cerebrovascular events (MACCE), including all-cause death, stroke, and myocardial infarction at 5 year. The mean duration of follow up was 4.3 ± 1.7 years. The average patient age was 80.9 ± 4.3 years. MACCE was observed in 61 (40.9%) patients in the lowest TCBI quartile group. Kaplan-Meier analysis demonstrated an inverse relationship between MACCE and TCBI (log-lank P < 0.001). Multivariate analysis demonstrated that low TCBI significantly predicted the incidence of MACCE (hazard ratio: 1.44, 95% confidence interval: 1.03-2.00; P = 0.031). The TCBI is useful in predicting long-term outcomes in elderly patients undergoing PCI.

摘要

营养状况是一种评估心血管疾病患者预后的新方法。然而,由于老年患者与年轻患者之间存在显著差异,因此评估老年患者的营养状况具有挑战性。TCBI(甘油三酯×总胆固醇×体重指数)是一种用于预测冠心病患者长期结局的新的简单营养指数。这项回顾性研究评估了 TCBI 在纳入 SHINANO 5 年注册研究的 597 名老年(≥75 岁)患者中的疗效。SHINANO 5 年注册研究是一项前瞻性观察性多中心队列研究,共纳入了 1501 名接受选择性/紧急经皮冠状动脉介入治疗(PCI)的连续患者。在这项研究中,患者被分为 TCBI 四分位组。主要终点是 5 年内主要不良心脏和脑血管事件(MACCE)的发生,包括全因死亡、卒中和心肌梗死。平均随访时间为 4.3±1.7 年。患者平均年龄为 80.9±4.3 岁。在 TCBI 最低四分位组的 61 名(40.9%)患者中观察到 MACCE。Kaplan-Meier 分析表明 MACCE 与 TCBI 呈负相关(对数秩 P<0.001)。多变量分析表明,低 TCBI 显著预测 MACCE 的发生(风险比:1.44,95%置信区间:1.03-2.00;P=0.031)。TCBI 可用于预测接受 PCI 的老年患者的长期结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/787d/7788017/5fe053e67696/380_2020_1659_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/787d/7788017/a2976e306011/380_2020_1659_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/787d/7788017/2a1fded93104/380_2020_1659_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/787d/7788017/5fe053e67696/380_2020_1659_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/787d/7788017/a2976e306011/380_2020_1659_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/787d/7788017/2a1fded93104/380_2020_1659_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/787d/7788017/5fe053e67696/380_2020_1659_Fig3_HTML.jpg

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