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Impact of glycemic control status on patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention

血糖控制状况对 ST 段抬高型心肌梗死患者经皮冠状动脉介入治疗的影响

  • 影响因子:2.06
  • DOI:10.1186/s12872-020-01339-x
  • 作者列表:"Yan Li","Xiaowen Li","Yinhua Zhang","Leimin Zhang","Qingqing Wu","Zhaorun Bai","Jin Si","Xuebing Zuo","Ning Shi","Jing Li","Xi Chu
  • 发表时间:2020-02-02
Abstract

Abstract Background The combined effects of diabetes mellitus (DM), admission plasma glucose (APG), and glycated hemoglobin (HbA1c) levels on predicting long-term clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) are unknown. Therefore, we evaluated their combined effects on long-term clinical outcomes in STEMI patients treated with pPCI. Methods In total, 350 consecutive patients with STEMI undergoing pPCI were enrolled. Patients were divided into 3 groups according to DM history and APG and HbA1c levels. The cumulative rates of 24-month all-cause deaths and major adverse cardiac and cerebrovascular events (MACCEs) were calculated. Results Both the incidence of all-cause deaths and cumulative rates of MACCEs were significantly the lowest in patients without a DM history and admission HbA1c level  1 correlated with 24-month all-cause death; HbA1c levels on admission, DM history, APG levels, history of stroke, history of coronary heart disease, and TG levels on admission were significantly associated with MACCEs through the 24-month follow-up. The predictive effects of combining DM and APG and HbA1c levels were such that for STEMI patients undergoing pPCI, DM patients with poor glycemic control or with stress hyperglycemia on admission had worse prognosis than other patients. Conclusion Strict control of glycemic status may improve the survival of patients who have both DM and coronary heart diseases.

摘要

摘要: 背景: 糖尿病 (DM) 、入院血糖 (APG) 、糖化血红蛋白 (HbA1c) 的联合作用对接受直接经皮冠状动脉介入治疗 (pPCI) 的 ST 段抬高型心肌梗死 (STEMI) 患者的长期临床结局的预测水平尚不清楚。因此,我们评价了它们对 pPCI 治疗的 STEMI 患者长期临床结局的综合影响。方法连续入选 350 例接受 pPCI 的 STEMI 患者。根据 DM 史及 APG 、 HbA1c 水平将患者分为 3 组。计算 24 个月全因死亡和主要心脑血管不良事件 (MACCEs) 的累积率。结果无 DM 史患者的全因死亡发生率和 MACCEs 累积率均显著最低,入院 HbA1c 水平与 24 个月全因死亡相关; 入院时 HbA1c 水平、 DM 史、 APG 水平、脑卒中史、冠心病史、在 24 个月的随访中,入院时的 TG 水平与 MACCEs 显著相关。合并 DM 和 APG 及 HbA1c 水平的预测作用是,对于接受 pPCI 的 STEMI 患者,血糖控制不佳或入院时伴有应激性高血糖的 DM 患者预后比其他患者更差。结论严格控制血糖状态可提高糖尿病合并冠心病患者的生存率。

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影响因子:4.65
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DOI:10.1161/ATVBAHA.119.313602
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