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患有心力衰竭住院的老年患者入院葡萄糖和死亡率升高
Mikhail Kosiborod1, Silvio E Inzucchi, John A Spertus
1Mid America Heart Institute of Saint Luke's Hospital, Kansas City, MO 64111, USA. mkosiborod@cc-pc.com
Circulation
|April 1, 2009
概括
心力衰竭患者的高血糖并不显著增加死亡风险. 这项研究在住院心力衰竭患者中发现血糖升高和死亡之间没有联系,这挑战了现有的指导方针.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 临床研究 临床研究
背景情况:
- 专业协会建议针对住院患者进行目标驱动的葡萄糖控制.
- 血糖升高与心力衰竭的不良结果之间的关联尚未得到充分证实.
研究的目的:
- 调查心力衰竭住院患者入院葡萄糖水平与死亡率之间的关联.
主要方法:
- 在美国 (1998-2001) 接受了50532名因心力衰竭住院的老年患者的全国代表性队列的分析.
- 多变量考克斯回归模型用于分析入院葡萄糖与30天和1年全因死亡率之间的关联.
- 在整个队列中进行分析,并按糖尿病状况分层.
主要成果:
- 在多变量调整后,在入院葡萄糖水平和30天死亡率之间没有发现显著的关系.
- 一年死亡率的结果是相似的,没有发现显著的关联.
- 这些发现在已知糖尿病患者和未患糖尿病患者之间没有差异.
结论:
- 在大量住院心力衰竭患者中,入院葡萄糖水平与死亡率没有显著相关.
- 过高血糖和急性心肌梗塞的不良结果之间的关系可能不适用于其他心血管疾病,如心力衰竭.
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