冠状动脉旁路移植后糖尿病和心力衰竭之间的关联:丹麦基于登记的队列研究
Benedicte Bay Oxholm Brodersen1, Line Tribler Kristiansen1, Sidsel le Fevre Karlsen1
1The Faculty of Medicine, Aalborg University, Aalborg, Denmark.
概括
患有糖尿病 (DM) 的患者在冠状动脉旁路移植 (CABG) 后面临心力衰竭 (HF) 的风险显著增加. 这种增加的风险在手术后持续长达十年,这突显了这一患者群体的关键问题.
科学领域:
- 心血管医学 心血管医学
- 糖尿病学 糖尿病学
- 手术结果研究研究.
背景情况:
- 缺血性心脏病 (IHD) 是全球主要的死亡原因.
- 糖尿病 (DM) 影响了大约25%的冠状动脉旁路移植 (CABG) 患者.
- 患有DM的患者表现出心力衰竭 (HF) 后重血管化的死亡风险增加.
研究的目的:
- 为了比较患有糖尿病 (DM) 和没有糖尿病的患者在冠状动脉旁路移植 (CABG) 后患心力衰竭 (HF) 的风险.
主要方法:
- 一项大型,全国性的基于登记的队列研究包括了2000年至2020年期间接受CABG的患者.
- 考克斯回归和g-formula方法被用来分析DM状态和HF结果之间的关联.
- 绝对风险 (AR) 和风险差异 (RD) 计算了HF和死亡率.
主要成果:
- 该研究包括34,855名患者,其中19.8%患有DM.
- 在CABG后10年的绝对HF风险为DM患者的35.1%,而非DM患者的26.4% (p < 0.001).
- 在DM患者中,HF风险差异显著更高,从3.7个百分点 (pp) 增加到3.7个百分点 (pp). 在1年到8.6年 pp. 在第10年.
结论:
- 患有糖尿病 (DM) 的患者在冠状动脉旁路移植 (CABG) 后心力衰竭 (HF) 的风险显著增加.
- 在DM患者中,这种增加的HF风险在CABG后持续长达10年.
- 这些发现强调了在接受CABG的患者中管理DM的重要性,以减轻长期的HF风险.
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