中度高血糖增加接受经皮冠状动脉介入治疗的早发冠状动脉疾病患者全因死亡风险。

Intermediate Hyperglycemia Increases the Risk of All-Cause Mortality in Premature Coronary Artery Disease Patients Undergoing Percutaneous Coronary Intervention.

作者信息

Zhou Ziyou, Qiao Linfang, Ling Yihang, He Yibo, Chang Tian, Lu Hongyu, Yu Sijia, Liu Jin, Guo Wei, Chen Shiqun, Liu Yong, Chen Jiyan

机构信息

School of Medicine, South China University of Technology, 510006 Guangzhou, Guangdong, China.

Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 510080 Guangzhou, Guangdong, China.

出版信息

Rev Cardiovasc Med. 2023 Dec 13;24(12):352. doi: 10.31083/j.rcm2412352. eCollection 2023 Dec.

DOI:10.31083/j.rcm2412352

PMID:39077077

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11272885/

Abstract

BACKGROUND

Hyperglycemia has been associated with an adverse prognosis in patients with premature coronary artery disease (CAD). However, whether the intermediate hyperglycemia status affects the risk of mortality in premature CAD patients treated with percutaneous coronary intervention (PCI), remains unclear.

METHODS

We retrospectively included 14,585 premature CAD patients undergoing PCI from 2007 to 2020. Patients were divided into normal glycemia ( 6%), intermediate hyperglycemia (6%-6.5%), and hyperglycemia ( 6.5%) according to hemoglobin A1c (HbA1c) level in whole blood. Follow-up all-cause mortality was defined as a primary outcome, and Cox proportional regression analysis was used to assess the association between glycemia status and the primary outcome.

RESULTS

Among 14,585 premature CAD patients undergoing PCI (mean age 43.6 7.6 years, 28.1% female), 2856 (19.6%) were diagnosed with intermediate hyperglycemia. Over a median follow-up of 4.62 years (2.72-7.19 years), patients with hyperglycemia were correlated with higher risk (hazard ratio [HR] 1.35, 95% confidence interval [CI] 1.19-1.54, 0.001) while patients with intermediate hyperglycemia were associated with intermediate mortality risk from all causes (HR 1.17, 95% CI 1.0-1.36, = 0.049).

CONCLUSIONS

Intermediate hyperglycemia was positively associated with all-cause mortality risk in patients with premature CAD undergoing PCI. Active glucose-lowering therapy may be considered in these patients.

CLINICAL TRIAL REGISTRATION

NCT05050877.

摘要

背景

高血糖与早发冠心病（CAD）患者的不良预后相关。然而，中等程度的高血糖状态是否会影响接受经皮冠状动脉介入治疗（PCI）的早发CAD患者的死亡风险，仍不清楚。

方法

我们回顾性纳入了2007年至2020年期间接受PCI的14585例早发CAD患者。根据全血糖化血红蛋白（HbA1c）水平，将患者分为正常血糖（<6%）、中等程度高血糖（6% - 6.5%）和高血糖（>6.5%）三组。将随访期间的全因死亡率定义为主要结局，并采用Cox比例回归分析来评估血糖状态与主要结局之间的关联。

结果

在14585例接受PCI的早发CAD患者中（平均年龄43.6±7.6岁，女性占28.1%），2856例（19.6%）被诊断为中等程度高血糖。在中位随访4.62年（2.72 - 7.19年）期间，高血糖患者的风险更高（风险比[HR]为1.35，95%置信区间[CI]为1.19 - 1.54，P<0.001），而中等程度高血糖患者的全因死亡风险处于中等水平（HR为1.17，95%CI为1.0 - 1.36，P = 0.049）。