Kim Yong Hoon, Her Ae-Young, Jeong Myung Ho, Kim Byeong-Keuk, Hong Sung-Jin, Park Sang-Ho, Kim Seunghwan, Kim Byung Gyu, Ahn Chul-Min, Kim Jung-Sun, Ko Young-Guk, Choi Donghoon, Hong Myeong-Ki, Jang Yangsoo
Division of Cardiology, Department of Internal Medicine, 85082Kangwon National University School of Medicine, Chuncheon, Republic of Korea.
Department of Cardiology, Cardiovascular Center, 65416Chonnam National University Hospital, Gwangju, Republic of Korea.
Angiology. 2023 Mar;74(3):227-241. doi: 10.1177/00033197221098283. Epub 2022 May 10.
The effects of hypertension on long-term outcomes according to glycemic status in patients with acute myocardial infarction (AMI) after successful implantation of newer-generation drug-eluting stents (DES) have not been fully investigated. In this retrospective cohort study, a total of 11,911 patients were classified into 6 groups according to their glycemic status and presence or absence of hypertension. The major outcome was major adverse cardiac events (MACE), defined as all-cause death, recurrent myocardial infarction (Re-MI), or any revascularization. In patients without hypertension, the major outcomes were similar between the normoglycemia and prediabetes groups. However, MACE, all-cause death, cardiac death (CD), Re-MI rates were higher in patients with type 2 diabetes mellitus (T2DM) than in normoglycemic patients. Additionally, Re-MI was higher in patients with T2DM than in prediabetic patients. In patients with hypertension, although the major outcomes were similar between the prediabetes and T2DM groups, in both the prediabetes and T2DM groups, MACE, all-cause death, and CD rates were higher than those in the normoglycemia group. During a 2-year follow-up, the comparable harmful effects of hypertension in patients with AMI and prediabetes or T2DM were observed. Effective blood pressure and glucose control should be strengthened to reduce mortality in these patients.
新一代药物洗脱支架(DES)成功植入后,急性心肌梗死(AMI)患者中高血压对长期预后的影响,根据血糖状态尚未得到充分研究。在这项回顾性队列研究中,共有11911名患者根据其血糖状态以及是否存在高血压被分为6组。主要结局是主要不良心脏事件(MACE),定义为全因死亡、复发性心肌梗死(Re-MI)或任何血管重建。在无高血压患者中,血糖正常组和糖尿病前期组的主要结局相似。然而,2型糖尿病(T2DM)患者的MACE、全因死亡、心源性死亡(CD)、Re-MI发生率高于血糖正常患者。此外,T2DM患者的Re-MI高于糖尿病前期患者。在高血压患者中,虽然糖尿病前期组和T2DM组的主要结局相似,但在糖尿病前期组和T2DM组中,MACE、全因死亡和CD发生率均高于血糖正常组。在2年随访期间,观察到AMI合并糖尿病前期或T2DM患者中高血压具有类似的有害影响。应加强有效的血压和血糖控制以降低这些患者的死亡率。