风险因子水平的范围:控制,死亡率和心血管结果
Aidin Rawshani1, Araz Rawshani2, Stefan Franzén2
1From Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Sweden (Aidin Rawshani, Araz Rawshani, B.E., A. Rosengren); Swedish National Diabetes Register, Center of Registers in Region, Gothenburg, Sweden (Aidin Rawshani, Araz Rawshani, S.F., B.E., A.-M.S., M.M., S.G.); Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (D.K.M.); and Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK (N.S.). aidin.rawshani@gu.se.
患有1型糖尿病 (T1DM) 的人面临更高的心血管风险. 即使达到治疗目标,T1DM患者的死亡率和不良结果也比一般人群增加.
科学领域:
- 心脏病学
- 内分泌学
- 公共卫生
背景情况:
- 1型糖尿病 (T1DM) 与心血管并发症的风险显著增加有关.
- 与一般人群相比,在达到治疗目标的T1DM患者中,死亡率和心血管事件的残留风险尚不清楚.
研究的目的:
- 与没有糖尿病的患者相比,研究心血管治疗目标的实现与T1DM患者的残留死亡风险和主要心血管不良结果之间的关联.
主要方法:
- 一项队列研究包括来自瑞典国家糖尿病登记处的33333名T1DM患者,与166529名对照患者进行匹配.
- 根据无法控制的危险因素数量对患者进行分类:糖化血红蛋白,血压,白蛋白尿,吸烟和LDL胆固醇.
- 该研究检查了与风险因素控制相关的全因死亡,心肌梗塞,心力衰竭住院和中风风险.
主要成果:
- 随着每一个额外的不受控制的风险因素,所有结果的风险都逐步增加.
- 即使控制了所有风险因素,T1DM患者的死亡率,心肌梗塞,心力衰竭和中风风险也比对照组高.
- 在T1DM患者中,即使控制了最佳风险因素,也发现急性心肌梗塞和心力衰竭住院的风险较高.
结论:
- 在T1DM中,不受控制的心血管风险因素数量与不良结果之间存在强烈的关联.
- 尽管达到治疗目标,但T1DM患者的残留风险较高,主要是心血管不良结果,特别是心肌梗塞和心力衰竭.
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