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年轻糖尿病合并急性冠状动脉综合征患者的临床转归和心血管相关事件。

Clinical Outcomes and Cardiovascular-Related Events in Young Diabetic Patients with Acute Coronary Syndrome.

机构信息

Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan.

Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110, Jordan.

出版信息

Vasc Health Risk Manag. 2022 Feb 17;18:55-60. doi: 10.2147/VHRM.S349209. eCollection 2022.

Abstract

BACKGROUND

Diabetes mellitus (DM) is considered a risk and prognostic factor for elderly patients with the acute coronary syndrome (ACS). However, less is known about the characteristics of this relationship among younger patients in the Middle Eastern population.

OBJECTIVE

To explore the Clinical outcomes of cardiovascular-related events in young DM patients (≤50 years of age) during hospitalization and up to one year of follow-up.

METHODS

We compared the clinical features, in-hospital and one-year outcomes in young ACS diabetic patients with young ACS non-diabetic patients in 12 tertiary care centers in Jordan.

RESULTS

A total of 3517 ACS patients were included initially, 1031 of whom (29.3%) were <50-year-old. Of those, 385 (37.3%) had DM. Compared with young non-diabetic patients, young diabetic patients were more likely to have a worse clinical baseline profile, which includes hypertension (53.2% vs 26.0%, p < 0.001), dyslipidemia (32.5% vs 19.5%, p < 0.001), and multivessel coronary artery disease (40.9% vs 32.0%, p = 0.03). Furthermore, the diabetic group had more females than males (14.0% vs 5.9%, p < 0.001) and a higher mean body mass index (28.8+4.7 kg/m 2 vs 27.9+4.0 kg/m2, p < 0.001). There were no differences between the two groups in the mortality rates during index hospitalization (0.39% vs 0.28%, p = 0.63) or at one-year follow-up (1.6% vs 0.6%, p = 0.41). Also, no significant differences were observed in the rates of stent thrombosis (1.95% vs 1.97%, p = 0.78) or readmission for ACS or coronary revascularization (10.8% vs 7.6%, p = 0.14).

CONCLUSION

Despite a worse baseline clinical profile, young diabetic ACS patients did not have higher risks for in-hospital or one-year adverse cardiovascular events compared with the young non-diabetic ACS patients.

摘要

背景

糖尿病(DM)被认为是老年急性冠状动脉综合征(ACS)患者的风险和预后因素。然而,对于中东人群中年轻患者的这种关系的特征知之甚少。

目的

探讨住院期间和随访 1 年期间年轻(≤50 岁)糖尿病患者的心血管相关事件的临床结局。

方法

我们比较了在约旦 12 家三级护理中心的年轻 ACS 糖尿病患者与年轻 ACS 非糖尿病患者的临床特征、住院和 1 年结局。

结果

共纳入 3517 例 ACS 患者,其中 1031 例(29.3%)年龄<50 岁。其中 385 例(37.3%)患有糖尿病。与年轻非糖尿病患者相比,年轻糖尿病患者的临床基线特征更差,包括高血压(53.2%比 26.0%,p<0.001)、血脂异常(32.5%比 19.5%,p<0.001)和多支冠状动脉疾病(40.9%比 32.0%,p=0.03)。此外,糖尿病组女性多于男性(14.0%比 5.9%,p<0.001),平均体重指数(28.8+4.7kg/m2比 27.9+4.0kg/m2,p<0.001)更高。两组患者在指数住院期间(0.39%比 0.28%,p=0.63)或 1 年随访期间(1.6%比 0.6%,p=0.41)的死亡率无差异。两组患者支架血栓形成(1.95%比 1.97%,p=0.78)或因 ACS 再入院或冠状动脉血运重建(10.8%比 7.6%,p=0.14)的发生率也无显著差异。

结论

尽管年轻糖尿病 ACS 患者的基线临床特征较差,但与年轻非糖尿病 ACS 患者相比,其住院和 1 年不良心血管事件的风险并未增加。

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