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应激性心肌病患者高脂血症与住院结局的关联

The Association Between Hyperlipidemia and In-Hospital Outcomes in Takotsubo Cardiomyopathy.

作者信息

Li Pengyang, Lu Xiaojia, Teng Catherine, Hadley Michelle, Cai Peng, Dai Qiying, Wang Bin

机构信息

Department of Medicine, Saint Vincent Hospital, Worcester, MA 01608, USA.

Department of Cardiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong 515041, People's Republic of China.

出版信息

Diabetes Metab Syndr Obes. 2021 Jan 12;14:117-126. doi: 10.2147/DMSO.S282009. eCollection 2021.

Abstract

PURPOSE

Hyperlipidemia (HLD) is one of the most common cardiovascular risk factors and is prevalent in patients with takotsubo cardiomyopathy (TCM), but the association between HLD and TCM patients' outcomes is unclear. We investigated the impact of HLD on the in-hospital outcomes of TCM patients.

PATIENTS AND METHODS

Our retrospective cohort study used the latest available data from the National Inpatient Sample (2016-2017). Using the ICD-10 code, we identified 3139 patients with a primary diagnosis of TCM, 1530 of whom had HLD. We compared in-hospital outcomes between HLD and non-HLD groups before and after propensity score matching.

RESULTS

In the unmatched cohort, the HLD group had lower incidences of cardiac arrest, cardiogenic shock, and acute respiratory failure (ARF); shorter length of stay (LOS); and lower total charges (All p<0.05). In-hospital mortality (p=0.102) and ventricular arrhythmia (p=0.235) rates did not differ. After propensity score matching, the HLD group had lower rates of in-hospital mortality (1.1% vs 2.4%, p=0.027), ARF (9.1% vs 12.1%, p = 0.022) and cardiogenic shock (3.4% vs 5.6%, p=0.012), shorter LOS (3.20 ± 3.27 days vs 3.57 ± 3.14 days, p=0.005), and lower total charges (p=0.013). The matched groups did not differ significantly regarding cardiac arrest (p=0.141), ventricular arrhythmia (p=0.662) or acute kidney injury (AKI) (p = 0.167).

CONCLUSION

Counterintuitively, HLD was associated with better in-hospital outcomes in both the unmatched and propensity-matched cohorts of hospitalized TCM patients. Further studies are needed to investigate the mechanisms that may contribute to the association in TCM patients with HLD.

摘要

目的

高脂血症(HLD)是最常见的心血管危险因素之一,在应激性心肌病(TCM)患者中普遍存在,但HLD与TCM患者预后之间的关联尚不清楚。我们调查了HLD对TCM患者院内结局的影响。

患者与方法

我们的回顾性队列研究使用了国家住院患者样本(2016 - 2017年)的最新可用数据。使用国际疾病分类第十版(ICD - 10)编码,我们确定了3139例原发性诊断为TCM的患者,其中1530例患有HLD。我们在倾向得分匹配前后比较了HLD组和非HLD组的院内结局。

结果

在未匹配的队列中,HLD组心脏骤停、心源性休克和急性呼吸衰竭(ARF)的发生率较低;住院时间(LOS)较短;总费用较低(所有p<0.05)。院内死亡率(p = 0.102)和室性心律失常(p = 0.235)发生率无差异。倾向得分匹配后,HLD组院内死亡率较低(1.1%对2.4%,p = 0.027)、ARF(9.1%对12.1%,p = 0.022)和心源性休克(3.4%对5.6%,p = 0.012),LOS较短(3.20±3.27天对3.57±3.14天,p = 0.005),总费用较低(p = 0.013)。匹配组在心脏骤停(p = 0.141)、室性心律失常(p = 0.662)或急性肾损伤(AKI)(p = 0.167)方面无显著差异。

结论

与直觉相反,在未匹配和倾向得分匹配的住院TCM患者队列中,HLD均与较好的院内结局相关。需要进一步研究来调查可能导致HLD的TCM患者中这种关联的机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38f6/7811457/e7b830eb2216/DMSO-14-117-g0001.jpg

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