不稳定型心绞痛合并2型糖尿病患者外周反应性充血指数与冠状动脉斑块负荷及预后的关系

Relationships between peripheral reactive hyperemia index with coronary plaque burden and prognosis in patients with unstable angina pectoris complicated with type 2 diabetes mellitus.

作者信息

Yang Xiyan, Xing Yu, Xia Kun, Zhao Wenshu

机构信息

Heart Center, Beijing Chaoyang Hospital, Capital Medical University & Beijing Key Laboratory of Hypertension, Beijing, China.

出版信息

Ann Transl Med. 2021 Apr;9(8):655. doi: 10.21037/atm-21-657.

DOI:10.21037/atm-21-657

PMID:33987353

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8106013/

Abstract

BACKGROUND

Coronary plaque burden (CPB) is an important prognostic factor in patients with unstable angina pectoris (UAP). Our current study aims to investigate the relationships between peripheral reactive hyperemia index (RHI) with CPB and prognosis in patients with UAP complicated with type 2 diabetes mellitus (T2DM).

METHODS

The clinical data of 187 UAP-T2DM patients who were treated in our center from June 2017 to January 2019 were retrospectively collected. RHI, CPB, and other clinical features were measured. The patients were followed up for 18 months and then divided into an adverse cardiovascular event (ACE) group (n=71, with ACEs) and a control group (n=116, without ACEs). The differences in RHI, CPB, and other clinical features between these two groups were compared, and the potential correlation between RHI and CPB was analyzed.

RESULTS

Compared with the control group, the ACE group had significantly lower RHI (1.21±0.32 1.59±0.35, P=0.000) and left ventricular ejection fraction (LVEF) (42.92%±7.78% 48.90%±6.76%, P=0.000) and a significantly higher left ventricular myocardial mass index (2.67±0.87 2.27±0.49 mg/g, P=0.000), carotid intima-media thickness (1.65±0.34 1.51±0.32 mm, P=0.000), number of coronary plaques (3.98±0.53 3.32±0.38, P=0.000), non-calcified plaque volume (32.89±12.56 22.58±9.97 mm, P=0.000), calcified plaque volume (4.89±1.29 3.88±1.05 mm, P=0.000), non-calcified plaque burden (5.70%±1.60% 3.18%±1.08%, P=0.000), and calcified plaque burden (0.90%±0.22% 0.65%±0.19%, P=0.000). Pearson linear correlation analysis showed that peripheral RHI was negatively correlated with plaque number, non-calcified plaque volume, calcified plaque volume, non-calcified plaque burden, and calcified plaque burden in patients with UAP complicated with T2DM (all P<0.05).

CONCLUSIONS

Decreased peripheral RHI is associated with ACEs and CPB in patients with UAP complicated with T2DM.

摘要

背景

冠状动脉斑块负荷（CPB）是不稳定型心绞痛（UAP）患者的重要预后因素。我们当前的研究旨在探讨外周反应性充血指数（RHI）与CPB及UAP合并2型糖尿病（T2DM）患者预后之间的关系。

方法

回顾性收集2017年6月至2019年1月在我们中心接受治疗的187例UAP-T2DM患者的临床资料。测量RHI、CPB及其他临床特征。对患者进行18个月的随访，然后分为不良心血管事件（ACE）组（n = 71，发生ACE）和对照组（n = 116，未发生ACE）。比较两组之间RHI、CPB及其他临床特征的差异，并分析RHI与CPB之间的潜在相关性。

结果

与对照组相比，ACE组的RHI（1.21±0.32对1.59±0.35，P = 0.000）和左心室射血分数（LVEF）（42.92%±7.78%对48.90%±6.76%，P = 0.000）显著降低，左心室心肌质量指数（2.67±0.87对2.27±0.49mg/g，P = 0.000）、颈动脉内膜中层厚度（1.65±0.34对1.51±0.32mm，P = 0.000）、冠状动脉斑块数量（3.98±0.53对3.32±0.38，P = 0.000）、非钙化斑块体积（32.89±12.56对22.58±9.97mm，P = 0.000）、钙化斑块体积（4.89±1.29对3.88±1.05mm，P = 0.000）、非钙化斑块负荷（5.70%±1.60%对3.18%±1.08%，P = 0.000）和钙化斑块负荷（0.90%±0.22%对0.65%±0.19%，P = 0.000）显著升高。Pearson线性相关分析显示，UAP合并T2DM患者外周RHI与斑块数量、非钙化斑块体积、钙化斑块体积、非钙化斑块负荷和钙化斑块负荷呈负相关（均P<0.05）。