The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, Sichuan, China.
Department of Geriatric, The Zigong Affiliated Hospital, Southwest Medical University, Zigong, Sichuan, China.
BMJ Open. 2024 Nov 1;14(10):e082964. doi: 10.1136/bmjopen-2023-082964.
To examine the association between the sarcopenia index (SI) and the risk of intraprocedural events and post-discharge death during percutaneous coronary intervention (PCI).
A retrospective cohort study.
The study was conducted at a teaching hospital in Western China.
The participants were patients aged 45 years and older who underwent PCI at the hospital and had an estimated glomerular filtration rate (eGFR) of ≥15 mL/min/1.73 m. Patients who died during hospitalisation, as well as those with unknown death dates, those lost to follow-up and those with missing information for the SI calculation, were excluded.
The SI was calculated as serum creatinine/cystatin C (Cr/CysC) × 100. The high-SI group was defined as the highest quartile, while the remaining participants were included in the low-SI group. Intraprocedural events included intraprocedural coronary slow flow (CSF)/coronary artery no-reflow (CNR) and malignant ventricular arrhythmia (MVA). In the event of death, the date of death was recorded.
The study included 497 patients who underwent PCI in our hospital, of whom 369 (74.25%) were males. A total of 57 (11.47%) patients developed CSF, 100 (20.12%) developed CNR and 4 (0.8%) developed MVA. Forty-four (8.85%) patients died post-discharge. The proportion of patients in the low-SI group who developed CSF was higher than those who did not (16.94% vs 9.65%, p=0.027). In addition, the average SI was lower in patients who developed CSF than in those who did not (81.99 vs 87.11, p=0.043). After adjusting for possible confounding factors, logistic regression analysis showed that the risk of CSF in the low-SI group was higher than that in the high-SI group (OR = 2.01, 95% CI: 1.04 to 3.89). In addition, it was found that the lower the SI, the higher the risk of CSF (OR = 0.983, 95% CI: 0.967 to 0.999).
Patients with lower SI had a greater risk of developing CSF, and the lower the SI, the higher the risk of CSF. However, these data suggest that SI is not associated with CNR and the risk of post-discharge death in patients after PCI.
探讨肌少症指数(SI)与经皮冠状动脉介入治疗(PCI)过程中事件和出院后死亡风险的关系。
回顾性队列研究。
研究在我国西部的一家教学医院进行。
年龄在 45 岁及以上,在该医院接受 PCI 治疗且估计肾小球滤过率(eGFR)≥15ml/min/1.73m²的患者。排除住院期间死亡、死因不详、失访以及无法计算 SI 的患者。
SI 计算方法为血清肌酐/胱抑素 C(Cr/CysC)×100。高 SI 组定义为最高四分位组,其余患者归入低 SI 组。术中事件包括术中冠状动脉慢血流(CSF)/无复流(CNR)和恶性室性心律失常(MVA)。若患者死亡,则记录死亡日期。
本研究纳入了在我院接受 PCI 的 497 例患者,其中 369 例(74.25%)为男性。57 例(11.47%)患者发生 CSF,100 例(20.12%)发生 CNR,4 例(0.8%)发生 MVA。44 例(8.85%)患者出院后死亡。低 SI 组发生 CSF 的患者比例高于未发生 CSF 的患者(16.94% vs. 9.65%,p=0.027)。此外,发生 CSF 的患者平均 SI 低于未发生 CSF 的患者(81.99 vs. 87.11,p=0.043)。调整可能的混杂因素后,logistic 回归分析显示,低 SI 组发生 CSF 的风险高于高 SI 组(OR=2.01,95%CI:1.04 至 3.89)。此外,还发现 SI 越低,CSF 发生的风险越高(OR=0.983,95%CI:0.967 至 0.999)。
SI 较低的患者发生 CSF 的风险较高,且 SI 越低,发生 CSF 的风险越高。然而,这些数据表明,SI 与 PCI 后患者的 CNR 和出院后死亡风险无关。