Xiang Lu, Zhang Min, Wu Hongying, Xie Dili
Department of Geriatric Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; Chinese Academy of Sciences, Sichuan Translational Medicine Research Hospital, Chengdu, China.
Chinese Academy of Sciences, Sichuan Translational Medicine Research Hospital, Chengdu, China; Department of Outpatients, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Ann Palliat Med. 2021 Apr;10(4):4463-4471. doi: 10.21037/apm-21-425. Epub 2021 Apr 16.
This study explored the levels and prognostic value of ischemia modified albumin (IMA), red blood cell distribution width (RDW), and lipoprotein (LP) in patients with diabetes melltus (DM) complicated withcoronary heart disease (CHD).
A total of 95 patients with DM who were diagnosed and treatedfrom January 2018 to January 2019 were retrospectively analyzed. All included patients underwent percutaneous coronary intervention (PCI). Patients with DM complicated with CHDwere designated group A (n=61) and patients without CHD complications were designated group B (n=34). During the same period, 45 patients without DM who underwent physical examination in our hospital were included as a control group.The levels of IMA, LP, and RDW in the 3 groups of patients were compared. The study examined the occurrence of cardiovascular events after PCI treatment in patients with DM complicated with CHD, and the related risk factors were assessed using multivariate logistic regression analysis. Furthermore, the receiver operating characteristic (ROC) curve was used to analyze the value of IMA, LP, and RDW in predicting cardiovascular events in DM patients complicated with CHD.
The levels of IMA, LP, and RDW werehigher in groups A and B compared to the control group (P<0.05). In patients who experienced a cardiovascular event, the levels of IMA, LP, and RDW were higher than those observed in patients who did not experience a cardiovascular event (P<0.05). The area under the ROC curve of IMA, LP, RDW, and the combination of the three factors for the prediction of cardiovascular events were 0.910, 0.774, 0.846, and 0.995, respectively. The combined detection of the 3 factors showed the best predictive value.Patients with abnormal values in blood lipids, blood creatinine, IMA, LP, and RDW had a significantly poorer prognosis in terms of adverse cardiovascular events (P<0.05). The unconditional multivariate logistic regression model showed that abnormal levels of blood creatinine, IMA, LP, and RDW were independent risk factors for cardiovascular events in patients with DM complicated with CHD after PCI treatment (P<0.05).
The levels of IMA, RDW, and LP wereincreased in patients with DM complicated with CHD. Furthermore, abnormal levels of IMA, LP, and RDW are independent risk factors that affect cardiovascular events in these patients following PCI treatment. The combined detection of all three indicators may be an effective means to predict the prognosis of these patients.
本研究探讨了缺血修饰白蛋白（IMA）、红细胞分布宽度（RDW）和脂蛋白（LP）在糖尿病（DM）合并冠心病（CHD）患者中的水平及预后价值。
回顾性分析2018年1月至2019年1月期间诊断并接受治疗的95例DM患者。所有纳入患者均接受经皮冠状动脉介入治疗（PCI）。DM合并CHD患者被指定为A组（n = 61），无CHD并发症的患者被指定为B组（n = 34）。同期，将在我院接受体检的45例无DM患者纳入作为对照组。比较3组患者的IMA、LP和RDW水平。本研究考察了DM合并CHD患者PCI治疗后心血管事件的发生情况，并采用多因素logistic回归分析评估相关危险因素。此外，采用受试者工作特征（ROC）曲线分析IMA、LP和RDW在预测DM合并CHD患者心血管事件中的价值。
A组和B组的IMA、LP和RDW水平均高于对照组（P < 0.05）。发生心血管事件的患者的IMA、LP和RDW水平高于未发生心血管事件的患者（P < 0.05）。IMA、LP、RDW以及三者联合预测心血管事件的ROC曲线下面积分别为0.910、0.774、0.846和0.995。三项指标联合检测显示出最佳预测价值。血脂、血肌酐、IMA、LP和RDW值异常的患者在不良心血管事件方面的预后明显较差（P < 0.05）。无条件多因素logistic回归模型显示，血肌酐、IMA、LP和RDW水平异常是DM合并CHD患者PCI治疗后心血管事件的独立危险因素（P < 0.05）。
DM合并CHD患者的IMA、RDW和LP水平升高。此外，IMA、LP和RDW水平异常是影响这些患者PCI治疗后心血管事件的独立危险因素。三项指标联合检测可能是预测这些患者预后的有效手段。
