标准化相角是否可预测急性心肌梗死患者短期和长期不良心血管事件？一项队列研究。

Is the standardized phase angle a predictor of short- and long-term adverse cardiovascular events in patients with acute myocardial infarction? A cohort study.

机构信息

Postgraduate Program in Nutrition, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Brazil.

Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil.

出版信息

Nutrition. 2022 Nov-Dec;103-104:111774. doi: 10.1016/j.nut.2022.111774. Epub 2022 Jun 17.

DOI:10.1016/j.nut.2022.111774

PMID:35872408

Abstract

OBJECTIVES

Acute myocardial infarction (AMI) is myocardial necrosis resulting from myocardial ischemia, and its risk factors are usually a combination of the consumption of tobacco, inadequate diet, obesity, and a sedentary lifestyle, in addition to preexisting comorbidities. These risk factors may compromise cellular integrity, affecting physiologic and nutritional components. The phase angle (PhA) has been measured by bioelectrical impedance analysis (BIA) to identify the quality of the cell membrane and the distribution of body fluids. The aim of this study was to verify if the standardized PhA (SPhA) is a predictor of short- and long-term adverse cardiovascular events in patients after AMI.

METHODS

This was a prospective cohort study including hospitalized adult patients with a diagnosis of AMI. Demographic, clinical, and nutritional data were collected. The PhA was calculated through the measuring of the resistance (R) and reactance (Xc) from BIA, and it was adjusted based on reference values for sex and age, presenting, therefore, the SPhA. Low SPhA was defined as that <10th percentile of distribution. Hospital length of stay (LOS) and major adverse cardiac events (MACE), such as new hospital admission for unstable angina, new MI, and cardiovascular mortality, were observed. The sample comprised 153 patients, with a mean age of 61.2 ± 12.6 y, with 57.5% being older adults.

RESULTS

Fifteen patients with low SPhA (values <-3.10) had a longer LOS compared with those with normal SPhA (median 14 versus 8 d, P = 0.007), and shorter time for the occurrence of death (320 versus 354 d, P = 0.024). In the multivariate analysis, an association was observed between SPhA and longer LOS (hazard ratio, 9.25; P = 0.005), but not with mortality and MACE (P > 0.05 for all).

CONCLUSION

SPhA was a predictor of longer LOS, but not of long-term adverse cardiac events in patients following AMI.

摘要

目的

急性心肌梗死（AMI）是由心肌缺血导致的心肌坏死，其危险因素通常是吸烟、饮食不当、肥胖和久坐不动的生活方式等因素的综合作用，此外还包括既往存在的合并症。这些危险因素可能会损害细胞完整性，影响生理和营养成分。相位角（PhA）已通过生物电阻抗分析（BIA）进行测量，以确定细胞膜的质量和体液的分布。本研究旨在验证 AMI 后患者的标准化 PhA（SPhA）是否可预测短期和长期不良心血管事件。

方法

这是一项前瞻性队列研究，纳入了住院的成人 AMI 患者。收集了人口统计学、临床和营养数据。通过 BIA 测量电阻（R）和电抗（Xc）来计算 PhA，并根据性别和年龄的参考值进行调整，从而得出 SPhA。低 SPhA 定义为分布的 <第 10 百分位数。观察住院时间（LOS）和主要不良心脏事件（MACE），如新不稳定型心绞痛、新 MI 和心血管死亡率的住院。该样本包括 153 名患者，平均年龄为 61.2 ± 12.6 岁，57.5%为老年人。

结果

15 名 SPhA 较低（值 <-3.10）的患者的 LOS 比 SPhA 正常的患者长（中位数 14 天比 8 天，P=0.007），且发生死亡的时间更短（320 天比 354 天，P=0.024）。多变量分析显示，SPhA 与 LOS 延长相关（风险比，9.25；P=0.005），但与死亡率和 MACE 无关（所有 P > 0.05）。