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Cardiovasc Diabetol:糖尿病(前期)患者经皮冠脉介入置入药物洗脱支架后的3年预后

2021-11-14 Nebula MedSci原创

糖尿病和糖尿病前期患者经皮冠状动脉介入治疗置入药物洗脱支架后的不良结局风险均明显高于血糖正常个体。

糖尿病与药物洗脱支架 (DES) 经皮冠状动脉介入治疗后的不良结果相关,但糖尿病前期是否也存在这种关联尚未明确。此外,在接受当代支架治疗的糖尿病前期患者中,还缺乏出血数据。因此,该研究评估了糖尿病前期和糖尿病患者在接受新一代药物洗脱支架治疗后的 3 年的缺血和出血结局。

这是一项事后分析研究,汇集了BIO-RESORT和BIONYX支架试验的患者水平的数据,这两项多中心随机试验在随机分组时均根据有无糖尿病进行了分层。受试者的血糖状态、糖化血红蛋白和空腹血糖水平以及有无进行降糖治疗均有明确记录。4330位患者中有4212位(97.3%)随访超过了3年。主要终点有靶血管治疗失败、心血管死亡、靶血管心肌梗死或靶血管重建。

三组受试者的靶血管治疗失败和心血管死亡率

血糖正常、糖尿病前期和糖尿病患者的基线心血管风险状况逐渐异常。血糖正常、糖尿病前期和糖尿病患者的主要终点发生率分别是6.1%(142/2353)、11.2%(54/489)和13.7%(197/1488);与血糖正常个体相比,糖尿病前期和糖尿病患者主要终点的风险比(HR)分别是1.89(95% CI 1.38-2.58, p<0.001)和2.30(1.85-2.86,p<0.001)。

三组受试者的靶血管心肌梗死或靶血管重建率

与血糖正常的个体相比,糖尿病前期患者的心血管死亡率和靶血管重建率均显著更高(HR 2.81, 95% CI 1.49-5.30,p=0.001,和HR 1.92, 95% CI 1.29-2.87, p=0.001);糖尿病患者的所有主要终点的发生率均更高(所有p≤0.001)。经过混杂因素校正后,结果保持一致。

三组受试者的大出血率

与血糖正常的个体相比,糖尿病前期和糖尿病患者的大出血率也显著更高(3.9%和4.1% vs 2.3%;HR 1.73, 95% CI 1.03-2.92, p=0.040 和 HR 1.78, 95% CI 1.23-2.57, p=0.002)。但是,经过混杂因素校正后,这些差异的显著性消失。

综上所述,不仅是糖尿病患者,糖尿病前期患者经皮冠状动脉介入治疗置入药物洗脱支架后的不良结局风险也明显升高

原始出处:

Ploumen, E.H., Pinxterhuis, T.H., Zocca, P. et al. Impact of prediabetes and diabetes on 3-year outcome of patients treated with new-generation drug-eluting stents in two large-scale randomized clinical trials. Cardiovasc Diabetol 20, 217 (2021). https://doi.org/10.1186/s12933-021-01405-4

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    2022-01-09 quxin068
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    2021-11-19 1591ff5c5cm

    不仅是糖尿病患者,糖尿病前期患者经皮冠状动脉介入治疗置入药物洗脱支架后的不良结局风险也明显升高。

    0

  6. 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  8. [GetPortalCommentsPageByObjectIdResponse(id=1761767, encodeId=24c21e6176742, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Tue Apr 05 18:32:10 CST 2022, time=2022-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1939270, encodeId=95dc19392e090, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, 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topicList=[TopicDto(id=65104, encryptionId=80936510423, topicName=洗脱支架)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e72268, createdName=zhixianchen, createdTime=Thu Dec 23 18:32:10 CST 2021, time=2021-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1071815, encodeId=289e10e181569, content=不仅是糖尿病患者,糖尿病前期患者经皮冠状动脉介入治疗置入药物洗脱支架后的不良结局风险也明显升高。, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9322143332, createdName=1591ff5c5cm, createdTime=Fri Nov 19 17:27:04 CST 2021, time=2021-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310520, encodeId=176b1310520c0, content=<a href='/topic/show?id=f70e8e78941' target=_blank style='color:#2F92EE;'>#药物洗脱支架#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, 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channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=676f5639577, createdName=ms1000001312727573, createdTime=Mon Nov 15 13:36:57 CST 2021, time=2021-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1070412, encodeId=45c110e04124c, content=good, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=676f5639577, createdName=ms1000001312727573, createdTime=Mon Nov 15 13:33:17 CST 2021, time=2021-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1070319, encodeId=a54910e0319b0, content=是极为不平静的一天。就是在这一, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, 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    2021-11-15 ms1000001312727573

    分享话题怎么搞

    0

  9. 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topicList=[TopicDto(id=65104, encryptionId=80936510423, topicName=洗脱支架)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e72268, createdName=zhixianchen, createdTime=Thu Dec 23 18:32:10 CST 2021, time=2021-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1071815, encodeId=289e10e181569, content=不仅是糖尿病患者,糖尿病前期患者经皮冠状动脉介入治疗置入药物洗脱支架后的不良结局风险也明显升高。, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9322143332, createdName=1591ff5c5cm, createdTime=Fri Nov 19 17:27:04 CST 2021, time=2021-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1310520, encodeId=176b1310520c0, content=<a href='/topic/show?id=f70e8e78941' target=_blank style='color:#2F92EE;'>#药物洗脱支架#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87789, encryptionId=f70e8e78941, topicName=药物洗脱支架)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=86b7385, createdName=lqrandywkz, createdTime=Tue Nov 16 13:32:10 CST 2021, time=2021-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1596086, encodeId=b791159608680, content=<a href='/topic/show?id=f2c4e8397a7' target=_blank style='color:#2F92EE;'>#经皮冠脉介入#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78397, encryptionId=f2c4e8397a7, topicName=经皮冠脉介入)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=298b18326857, createdName=shock_melon, createdTime=Tue Nov 16 13:32:10 CST 2021, time=2021-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1070413, encodeId=a1bb10e0413af, content=分享话题怎么搞, beContent=null, objectType=article, 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    2021-11-15 ms1000001312727573

    good

    0

  10. 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topicName=null, topicId=null, topicList=[TopicDto(id=87789, encryptionId=f70e8e78941, topicName=药物洗脱支架)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=86b7385, createdName=lqrandywkz, createdTime=Tue Nov 16 13:32:10 CST 2021, time=2021-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1596086, encodeId=b791159608680, content=<a href='/topic/show?id=f2c4e8397a7' target=_blank style='color:#2F92EE;'>#经皮冠脉介入#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78397, encryptionId=f2c4e8397a7, topicName=经皮冠脉介入)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=298b18326857, createdName=shock_melon, createdTime=Tue Nov 16 13:32:10 CST 2021, time=2021-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1070413, encodeId=a1bb10e0413af, content=分享话题怎么搞, beContent=null, objectType=article, 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authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Mon Nov 15 08:07:39 CST 2021, time=2021-11-15, status=1, ipAttribution=)]
    2021-11-15 查查佳佳

    是极为不平静的一天。就是在这一

    0

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