糖尿病患者主动脉瓣狭窄的心血管死亡率的发生率、危险因素和预测因素。

Incidence, risk factors and predictors of cardiovascular mortality for aortic stenosis among patients with diabetes mellitus.

机构信息

Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, National Taiwan University, Taipei, Taiwan.

Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.

出版信息

Diabetes Res Clin Pract. 2022 Sep;191:110050. doi: 10.1016/j.diabres.2022.110050. Epub 2022 Aug 27.

DOI:10.1016/j.diabres.2022.110050

PMID:36030901

Abstract

AIMS

To find the incidence, risk factors and predictors of cardiovascular (CV) mortality for aortic stenosis (AS) in patients with type 2 diabetes mellitus (T2DM).

METHODS

Between 2014 and 2019, 20,979 patients with T2DM who underwent echocardiography were enrolled for analysis. The mean follow-up period was 34 months. Multiple risk factors and outcomes for patients with and without AS were presented.

RESULTS

AS was present in 776 (3.70%) patients. Age, female, chronic kidney disease, hyperlipidemia, and peripheral arterial disease statistically increased risk of AS. The CV mortality (adjusted hazard ratio [aHR] = 1.97; 95% confidence interval [CI] 1.336 - 2.906, p < 0.001) and risk of hospitalization for heart failure (HHF) (aHR = 1.73, 95% CI 1.442-2.082, p < 0.001) were significantly increased in patients with AS, without significant differences in acute myocardial infarction and stroke. Severity of AS, body mass index (<27 kg/m), hypertension, hyperuricemia, left ventricular dysfunction (ejection fraction < 50%), and hematocrit (<38%) were significantly associated with increased CV mortality and HHF.

CONCLUSIONS

AS was associated with an increased risk of CV mortality and HHF in patients with T2DM.

摘要

目的

探讨 2 型糖尿病（T2DM）患者主动脉瓣狭窄（AS）的发生率、危险因素和预测因素及其与心血管（CV）死亡率的关系。

方法

2014 年至 2019 年间，共纳入 20979 例行超声心动图检查的 T2DM 患者进行分析。平均随访时间为 34 个月。分析了患者有无 AS 时的多种危险因素和结局。

结果

20979 例患者中，776 例（3.70%）存在 AS。年龄、女性、慢性肾脏病、血脂异常和外周动脉疾病均与 AS 的发生风险呈统计学相关。AS 患者的 CV 死亡率（校正风险比[aHR] 1.97；95%置信区间 1.336-2.906，p<0.001）和心力衰竭住院风险（HHF）（aHR 1.73，95%置信区间 1.442-2.082，p<0.001）显著升高，但急性心肌梗死和卒中等发生率无显著差异。AS 严重程度、体质指数（<27kg/m）、高血压、高尿酸血症、左心室功能障碍（射血分数<50%）和红细胞压积（<38%）与 CV 死亡率和 HHF 的升高显著相关。