心肌梗死后患者碳水化合物代谢紊乱及致死结局的预测因素：血糖水平的地位

Predictors of Carbohydrate Metabolism Disorders and Lethal Outcome in Patients after Myocardial Infarction: A Place of Glucose Level.

作者信息

Kononova Yulia, Abramyan Levon, Derevitskii Ilia, Babenko Alina

机构信息

World-Class Research Centre for Personalized Medicine, Almazov National Medical Research Centre, 197341 St. Petersburg, Russia.

出版信息

J Pers Med. 2023 Jun 14;13(6):997. doi: 10.3390/jpm13060997.

DOI:10.3390/jpm13060997

PMID:37373986

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10305089/

Abstract

BACKGROUND AND AIM

The aim of this study was to reveal statistical patterns in patients with acute myocardial infarction (AMI) that cause the development of carbohydrate metabolism disorders (CMD) (type 2 diabetes mellitus and prediabetes) and death within 5 years after AMI.

METHODS

1079 patients who were treated with AMI in the Almazov National Medical Research Center were retrospectively selected for the study. For each patient, all data from electronic medical records were downloaded. Statistical patterns that determine the development of CMDs and death within 5 years after AMI were identified. To create and train the models used in this study, the classic methods of Data Mining, Data Exploratory Analysis, and Machine Learning were used.

RESULTS

The main predictors of mortality within 5 years after AMI were advanced age, low relative level of lymphocytes, circumflex artery lesion, and glucose level. Main predictors of CMDs were low basophils, high neutrophils, high platelet distribution width, and high blood glucose level. High values of age and glucose together were relatively independent predictors. With glucose level >11 mmol/L and age >70 years, the 5-year risk of death is about 40% and it rises with increasing glucose levels.

CONCLUSION

The obtained results make it possible to predict the development of CMDs and death based on simple parameters that are easily available in clinical practice. Glucose level measured on the 1st day of AMI was among the most important predictors of CMDs and death.

摘要

背景与目的

本研究旨在揭示急性心肌梗死（AMI）患者中导致碳水化合物代谢紊乱（CMD，2型糖尿病和糖尿病前期）以及AMI后5年内死亡的统计模式。

方法

回顾性选取阿尔马佐夫国家医学研究中心1079例接受AMI治疗的患者进行研究。为每位患者下载电子病历中的所有数据。确定AMI后5年内CMD发生和死亡的统计模式。为创建和训练本研究中使用的模型，采用了数据挖掘、数据探索性分析和机器学习的经典方法。

结果

AMI后5年内死亡的主要预测因素是高龄、淋巴细胞相对水平低、回旋支动脉病变和血糖水平。CMD的主要预测因素是嗜碱性粒细胞低、中性粒细胞高、血小板分布宽度高和血糖水平高。年龄和血糖的高值共同构成相对独立的预测因素。当血糖水平>11 mmol/L且年龄>70岁时，5年死亡风险约为40%，且随血糖水平升高而增加。