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控制血清低密度脂蛋白胆固醇和甘油三酯对接受经皮冠状动脉介入治疗的糖尿病患者长期临床结局的影响。

Impact of Controlling Serum Low-Density Lipoprotein Cholesterol and Triglycerides on Long-Term Clinical Outcomes in Diabetic Patients Who Have Undergone Percutaneous Coronary Intervention.

作者信息

Maruo Takashi, Ike Amane, Takamiya Yosuke, Matsuoka Yuta, Shigemoto Eiji, Kato Yuta, Kuwano Takashi, Sugihara Makoto, Kawamura Akira, Miura Shin-Ichiro

机构信息

Department of Cardiology, Fukuoka University Chikushi Hospital Fukuoka Japan.

Department of Cardiology, Fukuoka University School of Medicine Fukuoka Japan.

出版信息

Circ Rep. 2024 Nov 7;6(12):573-582. doi: 10.1253/circrep.CR-24-0081. eCollection 2024 Dec 10.

Abstract

BACKGROUND

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).

METHODS AND RESULTS

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).

CONCLUSIONS

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.

摘要

背景

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。

方法与结果

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)。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3c3/11625774/c6ed7fd4997f/circrep-6-573-g001.jpg

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