在接受冠状动脉血管造影的患者中糖尿病和死亡风险:KARDIO研究
Jari A Laukkanen1,2, Setor K Kunutsor3, Jaakko Immonen2
1Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
概括
糖尿病增加了冠状动脉扫描患者的死亡风险,即使是严重的冠状动脉疾病 (CAD). 这种风险独立于其他因素,但可能受到家庭病史和吸烟状况的影响.
科学领域:
- 心脏病学 心脏病学
- 糖尿病学 糖尿病学
- 临床研究 临床研究
背景情况:
- 糖尿病是一种已知的心血管疾病和死亡风险因素.
- 糖尿病对患有广泛或扩散冠状动脉疾病 (CAD) 患者的死亡率的影响仍在争论中.
- 了解这种关系对于患者风险分层和管理至关重要.
研究的目的:
- 为了研究糖尿病和冠状动脉血管造影的患者的全因死亡率之间的联系.
- 为了确定这种联系是否独立于CAD严重程度和其他心血管风险因素而持续存在.
- 探索临床特征对糖尿病死亡率联系的潜在修改影响.
主要方法:
- 使用了KARDIO注册表,这是一个现实世界的临床数据库,包含79,738名患者.
- 分析了人口统计,并发症 (包括糖尿病),风险因素和冠状动脉血管学数据.
- 与糖尿病相关的全因死亡率的估计危险比率 (HRs),调整为多个变量.
主要成果:
- 在调整了混杂因素后,糖尿病与44%的死亡风险增加有关 (HR 1.44;95% CI 1.38-1.50).
- 即使对冠状动脉疾病的程度进行进一步调整 (HR 1.43;95% CI 1.36-1.49),这种增加的风险仍然显著.
- 这种关联在患有CAD家族病史的患者和前吸烟者中更为强烈.
结论:
- 糖尿病独立地增加了冠状动脉血管造影的患者的死亡风险.
- 冠状动脉疾病的严重程度并不能否定与糖尿病相关的高死亡风险.
- 糖尿病患者的家族病史和吸烟状况可能会改变糖尿病患者的死亡风险.
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