在稳定冠心病的糖尿病前期患者中最佳定义和风险分层:一项前性队列研究
Chenxi Song1,2,3, Zheng Qiao1,2,3, Jiaxi Cheng1,2,3
1Cardiometabolic Medicine Center, Fuwai Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China.
Journal of the American Heart Association
|December 24, 2024
概括
识别患有糖尿病前期和冠心病的高风险患者至关重要. 世界卫生组织 (WHO) 的定义和非常高风险标准有效地识别了那些患有重大心血管不良事件风险增加的人.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 公共卫生 公共卫生
背景情况:
- 在稳定的冠心病 (CHD) 患者中,糖尿病前期风险的最佳分层仍未得到充分研究.
- 目前的研究缺乏明确的方法来识别这一群体中的高风险个体.
研究的目的:
- 比较不同糖尿病前期定义的预后值.
- 评估"非常高风险" (VHR) 标准在患有稳定性心脏病的糖尿病前期患者的风险分层中的有用性.
主要方法:
- 这是一项针对7930名心血管疾病稳定患者的前性研究.
- 根据各种指导方针定义的糖尿病前期,并使用2018年AHA/ACC VHR标准进行分类.
- 主要终点:主要心血管不良事件 (MACE) 超过3年的中位随访.
主要成果:
- 糖尿病前期 (WHO/IEC标准) 增加了MACE的风险 (aHR, 1.484).
- 根据VHR标准,MACE风险显著增加 (aHR,1.783).
- 结合糖尿病前期和VHR标准,无论糖尿病前期的定义如何,都显示MACE风险较高.
结论:
- 世卫组织/国际专家委员会定义显示出预后价值.
- VHR标准对于稳定的心血管疾病的糖尿病前期患者的风险分层有价值.
- 结合方法有助于识别有针对性的干预措施的高风险个体.
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