摘要
目的探讨心脏代谢指数(CMI)与急性心肌梗死(AMI)患者冠脉病变程度及远期预后的相关性。方法纳入2018年1月至2019年12月期间就诊于新疆维吾尔自治区人民医院,明确诊断为AMI的712例患者作为研究对象,依据CMI三分位数将研究对象分为高、中、低值组。Gensini评分用以定量评估冠脉病变程度。终点事件定义为主要心血管不良事件(MACEs)的发生。采用Spearman相关性分析,探讨CMI与Gensini评分的相关性;采用多因素Cox回归分析MACEs发生的独立影响因素;采用限制性立方样条图分析CMI与MACEs发生风险之间的非线性关系;采用Kaplan-Meier曲线分析组间生存差异;亚组分析评估CMI对MACEs预测价值的一致性。结果Spearman相关性分析结果显示,CMI与Gensini评分呈正相关关系(r=0.13,P<0.001)。调整混杂后多因素Cox回归分析结果显示CMI是MACEs发生的独立危险因素(HR=1.709,95%CI 1.052~2.778,P=0.031)。限制性立方样条图分析结果显示,CMI与MACEs发生风险之间呈"L"形非线性效应关系(P=0.024)。Kaplan-Meier生存曲线分析结果显示:随着CMI升高,AMI患者MACEs累积发生率显著增加(P<0.05)。亚组间分析结果显示,CMI在不同亚组中对MACEs发生均具有独立的预测价值,并且在血脂正常、体型正常的患者中具有更高的预测价值。结论CMI与AMI患者冠脉病变程度密切相关,并且是远期MACEs发生的独立预测因子。
Objective To explore the correlation between cardiometabolic index(CMI)and the severity of coronary artery stenosis and long-term prognosis in patients with acute myocardial infarction(AMI).Methods A total of 712 patients with AMI who were admitted to the Xinjiang Uygur Autonomous Region People′s Hospital from January 2018 to December 2019 were included as the subjects.According to the tertile of CMI,the subjects were divided into high,medium,and low value groups.Gensini score was used to quantitatively assess the degree of coronary artery stenosis.The endpoint event was defined as the occurrence of major cardiovascular adverse events(MACEs).Spearman correlation analysis was conduceted to explore the correlation between CMI and Gensini score.Multivariate Cox regression was utilized to analyze the independent influencing factors of MACEs.A restricted cubic spline plot was employed to analyze the nonlinear relationship between CMI and the risk of MACEs.Kaplan-Meier curve was used to analyze survival differences between groups.Subgroup analysis was performed to evaluate the consistency of the predictive value of CMI for MACEs.Results Spearman correlation analysis showed that CMI was positively correlated with Gensini score(r=0.13,P<0.001).After adjusting for confounding,multivariate Cox regression analysis showed that CMI was an independent risk factor for MACEs(HR=1.709,95%CI 1.052-2.778,P=0.031).The restricted cubic spline analysis revealed an L-shaped nonlinear effect relationship between CMI and MACEs risk(P=0.024).Kaplan-Meier survival curve analysis demonstrated that the cumulative incidence of MACEs in AMI patients increased significantly with the increase of CMI(P<0.05).Subgroup analysis indicated that CMI independently predicted the occurrence of MACEs across different subgroups,and had higher predictive value in patients with normal lipids and normal body weight.Conclusion CMI is closely associated with the severity of coronary stenosis in AMI patients,and is an independent predictor of the risk of long-
作者
王凯阳
赖红梅
陶静
永佳蕙
李国庆
杨毅宁
Wang Kaiyang;Lai Hongmei;Tao Jing;Yong Jiahui;Li Guoqing;Yang Yining(Department of Cardiology,Xinjiang Uygur Autonomous Region People's Hospital,Xinjiang Key Laboratory of Cardiovascular Homeostasis and Regeneration Research,Urumqi 830000,China)
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2024年第8期647-653,共7页
Chinese Journal of Endocrinology and Metabolism
基金
新疆维吾尔自治区"科技创新领军人才项目-高层次领军人才"项目(2022TSYCLJ0028)。
