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糖化血红蛋白与冠状动脉疾病的血管造影严重程度:一项横断面研究。

Hemoglobin A1c and Angiographic Severity with Coronary Artery Disease: A Cross-Sectional Study.

作者信息

Yan Yugang, Gao Ronghua, Zhang Shaohui, Gao Zhencai, Chen Anyong, Wang Jianjun, Zhang Shufang, Dai Wen, Li Fen, Li Xiangting, Yang Guoliang, Liu Lixin, Chen Xueying

机构信息

School of Medical Engineering, Jining Medical University, Jining, Shandong, People's Republic of China.

The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, and The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, People's Republic of China.

出版信息

Int J Gen Med. 2022 Feb 15;15:1485-1495. doi: 10.2147/IJGM.S346525. eCollection 2022.

Abstract

BACKGROUND

Many studies have shown that glycated hemoglobin (HbA1c) is associated with coronary artery disease (CAD). HbA1c was independently related to angiographic severity in Chinese patients with CAD after adjusting for other covariates. Some traditional cardiovascular drugs may have an impact on this relationship.

METHODS

This retrospective study enrolled a total of 572 CAD patients who underwent their coronary angiography and had their HbA1c levels measured at the Chinese Hospital. The complexity of the coronary artery lesions was evaluated using the Syntax score, and the subjects were divided into 4 inter quartiles according to HbA1c levels. Covariates included history of traditional cardiovascular drugs.

RESULTS

The average age of selected participants was 61.00 ± 9.15 years old, and about 54.72% of them were male. Result of fully adjusted linear regression showed that HbA1c was positively associated with Syntax score after adjusting confounders (β = 1.09, 95% CI: 0.27, 1.91, P = 0.0096). By interaction and stratified analyses, the interactions were observed based on our specification including with the medication history of statins and angiotensin receptor blockers (ARBs) (P values for interaction <0.05).

CONCLUSION

In this study, we found a positive correlation between the HbA1c levels and the SYNTAX score among CAD individuals, and oral statins and ARBs medication could affect the correlation. Thus, HbA1c measurement could be used for the evaluation of the severity and complexity of coronary lesions among CAD patients.

摘要

背景

许多研究表明糖化血红蛋白(HbA1c)与冠状动脉疾病(CAD)相关。在中国CAD患者中,调整其他协变量后,HbA1c与血管造影严重程度独立相关。一些传统心血管药物可能会对这种关系产生影响。

方法

这项回顾性研究共纳入了572例在中国医院接受冠状动脉造影并测量了HbA1c水平的CAD患者。使用Syntax评分评估冠状动脉病变的复杂性,并根据HbA1c水平将受试者分为4个四分位数区间。协变量包括使用传统心血管药物的病史。

结果

入选参与者的平均年龄为61.00±9.15岁,其中约54.72%为男性。完全调整后的线性回归结果显示,调整混杂因素后,HbA1c与Syntax评分呈正相关(β = 1.09,95%可信区间:0.27,1.91,P = 0.0096)。通过交互作用和分层分析,在我们设定的条件下观察到了交互作用,包括与他汀类药物和血管紧张素受体阻滞剂(ARB)的用药史(交互作用P值<0.05)。

结论

在本研究中,我们发现CAD患者中HbA1c水平与SYNTAX评分之间存在正相关,口服他汀类药物和ARB药物可能会影响这种相关性。因此,HbA1c测量可用于评估CAD患者冠状动脉病变的严重程度和复杂性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e566/8857977/561aea4f4f2b/IJGM-15-1485-g0001.jpg

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