新型动脉粥样硬化指标在伴和不伴 2 型糖尿病的急性心肌梗死患者中的预后价值。

Prognostic value of novel atherogenic indices in patients with acute myocardial infarction with and without type 2 diabetes.

机构信息

Department of Internal Medicine, Diabetology and Cardiometabolic Disorders, Faculty of Medical Sciences Zabrze, Medical University of Silesia, Katowice, ul. M. Curie-Skłodowskiej 9, 41-800 Zabrze, Poland.

Third Department of Cardiology, Faculty of Medical Sciences Zabrze, Medical University of Silesia, Katowice, ul. M. Curie-Skłodowskiej 9, 41-800 Zabrze, Poland; Department of Cardiovascular Disease Prevention in Bytom, Medical University of Silesia, Katowice, Poland.

出版信息

J Diabetes Complications. 2024 Oct;38(10):108850. doi: 10.1016/j.jdiacomp.2024.108850. Epub 2024 Aug 24.

DOI:10.1016/j.jdiacomp.2024.108850

PMID:39191064

Abstract

AIMS

Atherogenic indices: Triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, Atherogenic Index of Plasma (AIP), Atherogenic Coefficient (AC), Castelli's Risk Index I and II (CRI-I, CRI-II) are used in clinical studies as surrogates of major adverse cardiac and cerebrovascular events (MACCE). Risk prediction of MACCE in patients with acute myocardial infarction (AMI) has vital role in clinical practice. We aimed to assess prognostic value of these indices following AMI.

METHODS

We analyzed patients with AMI with and without T2DM and the prognostic values of atherogenic indices for in-hospital death and MACCE within 12 months after AMI.

RESULTS

Of 2461 patients, 152 in-hospital deaths (6.2 %) were reported (74 patients [7.4 %] with T2DM and 78 [5.3 %] without T2DM; p = 0.042). MACCE occurred in 22.7 % of patients (29.7 % with T2DM and 17.9 % without T2DM; p < 0.001). TG/HDL-C and AIP were higher in T2DM patients compared to those without T2DM (p < 0.001). Long-term MACCE was more prevalent in patients with T2DM (p < 0.001). The AUC-ROC for predicting in-hospital death based on TG/HDL-C and AIP was 0.57 (p = 0.002).

CONCLUSIONS

None of the atherogenic indices was an independent risk factor for in-hospital death or MACCE at 12-month follow-up in patients with AMI. AIP was an independent risk factor for death at 12-month follow-up.

摘要

目的

载脂蛋白：甘油三酯与高密度脂蛋白胆固醇比值（TG/HDL-C）、血浆致动脉粥样硬化指数（AIP）、动脉粥样硬化系数（AC）、卡斯特利风险指数 I 和 II（CRI-I、CRI-II）在临床研究中被用作主要不良心脏和脑血管事件（MACCE）的替代指标。急性心肌梗死（AMI）患者的 MACCE 风险预测在临床实践中具有重要作用。我们旨在评估这些指标在 AMI 后的预后价值。

方法

我们分析了伴有和不伴有 2 型糖尿病的 AMI 患者，并评估了载脂蛋白指数对 AMI 后 12 个月内院内死亡和 MACCE 的预后价值。

结果

在 2461 例患者中，报告了 152 例院内死亡（6.2%）（74 例[7.4%]患有 2 型糖尿病，78 例[5.3%]无 2 型糖尿病；p=0.042）。22.7%的患者发生 MACCE（29.7%患有 2 型糖尿病，17.9%无 2 型糖尿病；p<0.001）。与无 2 型糖尿病的患者相比，患有 2 型糖尿病的患者 TG/HDL-C 和 AIP 更高（p<0.001）。患有 2 型糖尿病的患者长期 MACCE 更为常见（p<0.001）。基于 TG/HDL-C 和 AIP 预测院内死亡的 AUC-ROC 为 0.57（p=0.002）。