Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan.
Department of Cardiac Rehabilitation, Kitasato University Kitasato Institute Hospital, Minato-Ku, Japan.
Cardiovasc Diabetol. 2023 Aug 17;22(1):213. doi: 10.1186/s12933-023-01953-x.
The accumulation of advanced glycation end products (AGEs) is associated with cardiovascular events in patients with cardiovascular disease (CVD). However, the relationship between the AGEs measured by an AGEs sensor noninvasively at the fingertip and prognosis in patients with CVD remains unclear. Therefore, this study aimed to determine the relationship between AGEs score and prognosis among patients with CVD.
A total of 191 outpatients with CVD were included. AGEs score were measured using an AGEs sensor and the patients were classified into groups by the median value of AGEs score. The incidence of major adverse cardiovascular and cerebrovascular events (MACCE) at 30 months was compared between high- and low-AGEs score groups. In addition, receiver operating characteristic (ROC) curve analysis was used to calculate cutoff value for the AGEs score, which discriminates the occurrence of MACCE. Cox regression analysis was performed to identify the factors associated with the presence of MACCE. MACCE included cardiac death, myocardial infarction, percutaneous coronary intervention, heart failure, and stroke.
AGEs score was normally distributed, with a median value of 0.51. No significant intergroup differences were found in laboratory findings, physical functions, or medications. The high-AGEs score group had a significantly higher incidence of MACCE than the low-AGEs score group (27.1 vs. 10.5%, P = 0.007). A high-AGEs score was a risk factor for MACCE (hazard ratio, 2.638; 95% confidence interval, 1.271-5.471; P = 0.009). After the adjustment for confounders other than 6-min walking distance, the AGEs score remained a factor associated with the occurrence of MACCE. The best cutoff AGEs score for the detection of MACCE was 0.51 (area under the curve, 0.642; P = 0.008; sensitivity, 72.2%; specificity, 54.8%).
AGEs score measured at the fingertip in patients with CVD is associated with MACCE. AGEs score, which can be measured noninvasively and easily, may be useful as an assessment for the secondary prevention of CVD in patients with CVD.
在患有心血管疾病 (CVD) 的患者中，晚期糖基化终产物 (AGEs) 的积累与心血管事件有关。然而，通过指尖无创 AGEs 传感器测量的 AGEs 与 CVD 患者预后之间的关系尚不清楚。因此，本研究旨在确定 CVD 患者的 AGEs 评分与预后之间的关系。
共纳入 191 例 CVD 门诊患者。使用 AGEs 传感器测量 AGEs 评分，并根据 AGEs 评分中位数将患者分为高 AGEs 评分组和低 AGEs 评分组。比较 30 个月时主要不良心脑血管事件 (MACCE) 的发生率。此外，使用受试者工作特征 (ROC) 曲线分析计算 AGEs 评分的截断值，以区分 MACCE 的发生。采用 Cox 回归分析确定与 MACCE 发生相关的因素。MACCE 包括心脏死亡、心肌梗死、经皮冠状动脉介入治疗、心力衰竭和中风。
AGEs 评分呈正态分布，中位数为 0.51。实验室检查、身体功能或药物使用在两组间无显著差异。高 AGEs 评分组的 MACCE 发生率明显高于低 AGEs 评分组 (27.1% vs. 10.5%，P=0.007)。高 AGEs 评分是 MACCE 的危险因素 (风险比，2.638；95%置信区间，1.271-5.471；P=0.009)。在调整除 6 分钟步行距离以外的混杂因素后，AGEs 评分仍是 MACCE 发生的相关因素。检测 MACCE 的最佳 AGEs 评分截断值为 0.51（曲线下面积，0.642；P=0.008；敏感性，72.2%；特异性，54.8%）。
CVD 患者指尖测量的 AGEs 评分与 MACCE 相关。AGEs 评分可无创、简便地测量，可能有助于 CVD 患者 CVD 的二级预防评估。
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