Department of Cardiology, Chinese PLA General Hospital, Beijing 100853, China.
School of Medicine, Nankai University, Tianjin 300071, China.
J Diabetes Res. 2021 Jun 9;2021:5597467. doi: 10.1155/2021/5597467. eCollection 2021.
813 DM patients (mean age 58.9 ± 9.9 years, 48.1% male) referred for CCTA due to suspected CAD in 2015-2017 were consecutively included. During a median follow-up of 31.77 months, 50 major adverse cardiovascular events (MACEs) (6.15%) were experienced, including 2 cardiovascular deaths, 14 nonfatal myocardial infarctions, 27 unstable anginas requiring hospitalization, and 7 strokes. Three groups were defined based on coronary stenosis combined with Leiden score as normal, nonobstructive Leiden < 5, and nonobstructive Leiden ≥ 5. Cox models were used to assess the prognosis of plaque burden within these groups. An incremental incidence of MACE rates was observed. After adjustment for age, gender, and presence of high-risk plaque, the group of Leiden ≥ 5 showed a higher risk than Leiden < 5 (HR: 1.88, 95% CI: 1.03-3.42, = 0.039). Similar results were observed when segment involvement score (SIS) was used for sensitivity analysis.
Atherosclerotic extent was associated with the prognosis of DM patients with nonobstructive coronary artery disease, highlighting the importance of better risk stratification and management.
2015 年至 2017 年期间，连续纳入了 813 名因疑似 CAD 而接受 CCTA 检查的 DM 患者（平均年龄 58.9 ± 9.9 岁，48.1%为男性）。在中位随访 31.77 个月期间，50 名患者发生了主要不良心血管事件（MACEs）（6.15%），包括 2 例心血管死亡、14 例非致死性心肌梗死、27 例需要住院的不稳定型心绞痛和 7 例中风。根据冠状动脉狭窄程度和 Leiden 评分，将患者分为三组：正常、非阻塞性 Leiden<5 和非阻塞性 Leiden≥5。使用 Cox 模型评估这些组内斑块负荷的预后。观察到 MACE 发生率逐渐增加。在校正年龄、性别和高危斑块存在后，Leiden≥5 组的风险高于 Leiden<5 组（HR：1.88，95%CI：1.03-3.42，=0.039）。当使用节段受累评分（SIS）进行敏感性分析时，也观察到了类似的结果。
动脉粥样硬化程度与非阻塞性冠心病 DM 患者的预后相关，突出了更好的风险分层和管理的重要性。
