非ST段抬高型急性冠状动脉综合征患者接受经皮冠状动脉介入治疗时估计葡萄糖处置率的预后价值
Prognostic Value of Estimated Glucose Disposal Rate in Patients with Non-ST-Segment Elevation Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention.
作者信息
Liu Chi, Zhao Qi, Ma Xiaoteng, Cheng Yujing, Sun Yan, Zhang Dai, Zhou Yujie, Liu Xiaoli
机构信息
Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, 100029 Beijing, China.
Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, 100052 Beijing, China.
出版信息
Rev Cardiovasc Med. 2023 Jan 3;24(1):2. doi: 10.31083/j.rcm2401002. eCollection 2023 Jan.
BACKGROUND
Estimated glucose disposal rate (eGDR) is highly associated with all-cause mortality in type 2 diabetes mellitus (T2DM) cases undergoing coronary artery bypass grafting (CABG). Nevertheless, eGDR's prognostic value in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) following percutaneous coronary intervention (PCI) remains unknown.
METHODS
The population of this retrospective cohort study comprised NSTE-ACS patients administered PCI in Beijing Anzhen Hospital between January and December 2015. The primary endpoint was major adverse cardiac and cerebral events (MACCEs). eGDR was calculated based on waist circumference (WC) ( ) or body mass index (BMI) ( ).
RESULTS
Totally 2308 participants were included, and the mean follow-up time was 41.06 months. The incidence of MACCEs was markedly increased with decreasing eGDR. Multivariable analysis showed hazard ratios (HRs) for and of 1.152 (95% confidence interval [CI] 1.088-1.219; 0.001) and 0.998 (95% CI 0.936-1.064; = 0.957), respectively. Addition of to a model that included currently recognized cardiovascular risk factors markedly enhanced its predictive power compared with the baseline model (Harrell's C-index, versus Baseline model, 0.778 versus 0.768, = 0.003; continuous net reclassification improvement (continuous-NRI) of 0.125, 0.001; integrated discrimination improvement (IDI) of 0.016, 0.001).
CONCLUSIONS
Low eGDR independently predicts low survival of NSTE-ACS cases who underwent PCI.
背景
在接受冠状动脉旁路移植术（CABG）的2型糖尿病（T2DM）患者中，估计葡萄糖处置率（eGDR）与全因死亡率高度相关。然而，eGDR在经皮冠状动脉介入治疗（PCI）后的非ST段抬高型急性冠状动脉综合征（NSTE-ACS）中的预后价值仍不清楚。
方法
这项回顾性队列研究的人群包括2015年1月至12月在北京安贞医院接受PCI的NSTE-ACS患者。主要终点是主要不良心脑血管事件（MACCEs）。eGDR基于腰围（WC）（ ）或体重指数（BMI）（ ）计算。
结果
共纳入2308名参与者，平均随访时间为41.06个月。MACCEs的发生率随着eGDR的降低而显著增加。多变量分析显示，基于WC和BMI的风险比（HRs）分别为1.152（95%置信区间[CI]1.088-1.219； 0.001）和0.998（95%CI 0.936-1.064； = 0.957）。与仅包含当前公认的心血管危险因素的基线模型相比，将基于WC的eGDR添加到该模型中显著提高了其预测能力（Harrell氏C指数， 对基线模型，0.778对0.768， = 0.003；连续净重新分类改善（continuous-NRI）为0.125， 0.001；综合判别改善（IDI）为0.016， 0.001）。
结论
低eGDR独立预测接受PCI的NSTE-ACS患者的低生存率。
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