Maruo Takashi, Ike Amane, Takamiya Yosuke, Matsuoka Yuta, Shigemoto Eiji, Kato Yuta, Kuwano Takashi, Sugihara Makoto, Kawamura Akira, Miura Shin-Ichiro
Department of Cardiology, Fukuoka University Chikushi Hospital Fukuoka Japan.
Department of Cardiology, Fukuoka University School of Medicine Fukuoka Japan.
Circ Rep. 2024 Nov 7;6(12):573-582. doi: 10.1253/circrep.CR-24-0081. eCollection 2024 Dec 10.
We investigated whether patients with diabetes who had good control of both low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) would be associated with better long-term clinical outcomes after percutaneous coronary intervention (PCI).
Using our PCI registry (Fu-Registry), the 1,006 cases with diabetes were divided into 4 groups: Group 1, LDL-C ≥100 mg/dL and TG ≥175 mg/dL; Group 2, LDL-C <100 mg/dL and TG ≥175 mg/dL; Group 3, LDL-C ≥100 mg/dL and TG <175 mg/dL; and Group 4, LDL-C <100 mg/dL and TG <175 mg/dL. The primary endpoint during the follow-up period (median follow up of 1,984 days) was defined as major adverse cardiac events (MACEs). Additionally, all coronary events were defined as a secondary endpoint. The incidence rates of MACEs were as follows: Group 1, 38%; Group 2, 26%; Group 3, 31%; and Group 4, 27% (P=0.074), and the rates tended to be higher in Group 1. All coronary events were as follows: Group 1, 66%; Group 2, 56%; Group 3, 58%; and Group 4, 51% (P=0.032).
In patients with diabetes who underwent PCI, the LDL-C and TG levels in Group 4 met secondary prevention targets for coronary artery disease and these patients showed better long-term clinical outcomes compared with those in other groups.
我们研究了低密度脂蛋白胆固醇(LDL-C)和甘油三酯(TG)均得到良好控制的糖尿病患者在经皮冠状动脉介入治疗(PCI)后是否会有更好的长期临床结局。
利用我们的PCI注册登记系统(傅氏注册登记系统),将1006例糖尿病患者分为4组:第1组,LDL-C≥100mg/dL且TG≥175mg/dL;第2组,LDL-C<100mg/dL且TG≥175mg/dL;第3组,LDL-C≥100mg/dL且TG<175mg/dL;第4组,LDL-C<100mg/dL且TG<175mg/dL。随访期(中位随访时间为1984天)的主要终点定义为主要不良心脏事件(MACE)。此外,所有冠状动脉事件被定义为次要终点。MACE的发生率如下:第1组为38%;第2组为26%;第3组为31%;第4组为27%(P=0.074),第1组的发生率往往更高。所有冠状动脉事件的发生率如下:第1组为66%;第2组为56%;第3组为58%;第4组为51%(P=0.032)。
在接受PCI的糖尿病患者中,并接受PCI的糖尿病患者中,第4组的LDL-C和TG水平达到了冠状动脉疾病的二级预防目标,与其他组相比,这些患者显示出更好的长期临床结局。