糖尿病和非糖尿病患者患有血管痛的临床特征和主要不良心血管事件
Hiroki Teragawa1, Yuko Uchimura1, Chikage Oshita1
1Department of Cardiovascular Medicine, JR Hiroshima Hospital, Hiroshima, Japan.
概括
血管节炎 (VSA) 患者的糖尿病 (DM) 与更多的动脉样硬化病变有关. 虽然整体结果相似,但患有焦点的DM患者的生存率较低,需要针对性VSA治疗.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 血管医学 血管医学
背景情况:
- 糖尿病 (DM) 对血管性心痛 (VSA) 的临床意义和预后影响仍然不完全理解.
- 研究DM和VSA之间的相互作用对于完善患者管理策略至关重要.
研究的目的:
- 追溯调查DM和没有DM的VSA患者之间临床特征和预后影响的差异.
- 确定DM的存在是否会影响被诊断为VSA的患者的结果.
主要方法:
- 一项对272名通过冠状动脉血管造影 (CAG) 和诱导试验 (SPT) 诊断出VSA的日本患者的回顾性研究.
- 通过空腹血糖,HbA1c和药物病史确认DM诊断;通过CAG评估动脉样硬化病变.
- 重大心血管不良事件 (MACE),包括心脏死亡率和再住院,被追踪用于预后评估.
主要成果:
- 与非DM组相比,DM组 (18%) 的动脉样硬化病变率在CAG上显著更高 (46%对63%,P=0.028).
- 在SPT期间观察到DM组中较少的焦点的趋势 (24%对39%,P=0.072).
- 虽然总体MACE没有差异,但次分析显示,患有焦点的DM患者的MACE无生存率较低 (P=0.042).
结论:
- 在VSA患者中,糖尿病与动脉样硬化病变的更高患病率有关.
- 患有DM的VSA患者的焦点需要由于预后较差而增加临床关注.
- 建议对患有同时存在DM的VSA患者进行适当和向的治疗策略,特别是那些有焦点的患者.
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