在急性ST段升高心肌梗塞患者中,失糖症与持续性心脏病发作核心铁的相关性
Ivan Lechner1, Martin Reindl1, Fritz Oberhollenzer1
1University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria.
概括
持续的失糖症,指的是HbA1c升高,与心肌梗塞后的持续性心脏病核心铁有关. 这表明失糖症可能会阻碍铁的溶解,影响心脏组织的恢复.
科学领域:
- 心脏病学 心脏病学
- 代谢障碍 代谢障碍 代谢障碍
- 医疗成像医学成像
背景情况:
- 低血糖会增加心肌梗塞和复发性心血管事件的风险.
- 失糖症对缺血症/再输液损伤和心肌组织损伤的影响尚未完全理解.
- 调查失糖症在心脏病发作中的作用,对于了解长期结果至关重要.
研究的目的:
- 为了研究持续的失糖症和心脏病发作持续性之间的关联.
- 在ST段升高心肌梗塞 (STEMI) 患者中分析心脏梗塞核心铁的纵向变化.
- 探索糖化血红蛋白 (HbA1c) 水平和心脏病发作核心铁溶解后初级皮肤穿刺冠状动脉干预 (PCI) 之间的关系.
主要方法:
- 分析了348名接受初级PCI的STEMI患者,这些患者被纳入了MARINA-STEMI研究.
- 在入院时和入院后4个月内,收集周围静脉血液以测量葡萄糖和HbA1c.
- 用T2*映射进行心脏磁共振 (CMR) 成像,以在两个时间点评估心脏病发作核心的铁量,并使用多变量回归分析.
主要成果:
- 在基线时,内心肌出血发生在42%的患者中.
- 在4个月后,在61%的这些患者中观察到持续性心脏病核心铁,随着HbA1c水平的增加而增加.
- 即使在非糖尿病患者中,持续的失糖症 (HbA1c在4个月) 与持续的心脏病核心铁 (OR:7.87;p < 0.001) 独立相关.
结论:
- 由HbA1c定义的持续性失糖症与初级PCI治疗的STEMI患者的持续性心脏病核心铁独立相关.
- 低血糖症与心脏病发作的可能性降低有关.
- 进一步研究这种关联的治疗影响是有必要的.
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