Wang Mian, Yan Shaodi, Peng Yong, Shi Yu, Tsauo Jiay-Yu, Chen Mao
Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Shenzhen, 518057, China.
Shenzhen University School of Medicine, Shenzhen, 518060, China.
Open Med (Wars). 2020 Nov 9;15(1):1128-1136. doi: 10.1515/med-2020-0154. eCollection 2020.
Effect of serum calcium levels on prognosis of patients with coronary artery disease (CAD) is not well evaluated. We aimed to assess the associations of baseline serum calcium levels with both short-term and long-term outcomes in CAD patients.
This study included 3,109 consecutive patients with angiographically confirmed CAD. Patients were categorized into quartiles according to admission serum calcium. Multivariable regression analysis was used to determine the association of serum calcium with mortality.
Compared to patients in the lowest quartile of serum calcium, patients in upper quartiles were presented with lower all-cause mortality (Hazard ratios [HRs] were -0.636 [95% CI: -0.424 to -0.954], -0.545 [95% CI: -0.351 to -0.846] and -0.641 [95% CI: -0.450 to -0.913] for three upper quartiles versus lowest quartile respectively), cardiovascular mortality (HRs 0.594 [0.368-0.961], 0.261 [0.124-0.551] and 0.407 [0.229-0.725]), and in-hospital mortality (Odd ratios [ORs] 0.391 [0.188-0.812], 0.231 [0.072-0.501] and 0.223 [0.093-0.534]). Consistent associations between serum calcium and long-term mortality were also obtained in subgroup analysis of ACS patients, stable CAD patients and discharged patients.
Serum calcium is inversely associated with CAD and can independently predict both in-hospital and long-term mortality among CAD patients.
血清钙水平对冠状动脉疾病(CAD)患者预后的影响尚未得到充分评估。我们旨在评估CAD患者基线血清钙水平与短期和长期预后的相关性。
本研究纳入了3109例经血管造影证实患有CAD的连续患者。根据入院时的血清钙水平将患者分为四分位数。采用多变量回归分析来确定血清钙与死亡率之间的关联。
与血清钙水平处于最低四分位数的患者相比,处于较高四分位数的患者全因死亡率较低(三个较高四分位数与最低四分位数相比,风险比[HRs]分别为-0.636[95%置信区间:-0.424至-0.954]、-0.545[95%置信区间:-0.351至-0.846]和-0.641[95%置信区间:-0.450至-0.913])、心血管死亡率较低(HRs分别为0.594[0.368 - 0.961]、0.261[0.124 - 0.551]和0.407[0.229 - 0.725])以及住院死亡率较低(比值比[ORs]分别为0.391[0.188 - 0.812]、0.231[0.072 - 0.501]和0.223[0.093 - 0.534])。在急性冠状动脉综合征(ACS)患者、稳定型CAD患者和出院患者的亚组分析中,也获得了血清钙与长期死亡率之间的一致关联。
血清钙与CAD呈负相关,并且可以独立预测CAD患者的住院死亡率和长期死亡率。