中华医学杂志（英文版）2006，Vol.119Issue(22)：1871-1876,6.
Effect of metabolic syndrome on prognosis and clinical characteristics of revascularization in patients with coronary artery disease
Effect of metabolic syndrome on prognosis and clinical characteristics of revascularization in patients with coronary artery disease
HU Rong 1JIA Chang-qi 1LIU Xin-min 1DONG Jian-zeng 1LIU Xiao-hui 1CHEN Fang 1ZHOU Yu-jie 1L(U) Shu-zheng 1WU Xue-si 1MA Chang-sheng 1NIE Shao-ping 1L(U) Qiang 1KANG Jun-ping 1DU Xin 1ZHANG Yin 1GAO Ying-chun 1HE Li-qun1
作者信息
- 1. Department of Cardiology, Beijing Anzhen Hospital, Capital University of Medical Sciences, Beijing 100029, China
- 折叠
摘要
Abstract
Background People with metabolic syndrome are at higher risk for developing coronary artery disease (CAD).The effect of the metabolic syndrome on outcomes in patients with preexisting CAD has not been well studied.This study was conducted to assess the prevalence, characteristics, in hospital and long term prognosis of CAD with metabolic syndrome and to determine the factors influencing the prognosis of the disease.Methods The DESIRE registry contains data of 3696 patients with CAD between 2001 and 2004. Mean long term followup was (829±373) days. Diagnosis of metabolic syndrome was based on modified International Diabetes Federation (IDF) Worldwide Definition of the Metabolic Syndrome, using body mass index (BMI)instead of waist circumference.Results Of 2596 patients with complete records of height, weight, and so on, 1280 (49.3%) were identified with metabolic syndrome. The patients with metabolic syndrome had higher level of body mass index, systolic blood pressure, diastolic blood pressure, fasting glucose and disordered blood lipid (all P＜0.0001), with higher creatinine [(10.5±4.3) mg/L vs (9.9±2.9) mg/L, P＜0.0001] and the number of white blood cells [(7.49±2.86)× 109/L vs (7.19 ± 2.62) × 109/L, P=0.008) compared with those without metabolic syndrome. The patients with metabolic syndrome showed severer coronary angiographic alterations (left main artery and/or ≥2-vessel)(73.6% vs 69.6%, P=0.031). There were no significant differences of major adverse cardiac and cerebral events(MACCE) or mortality in hospital between the two groups. During followup, the ratio of MACCE in CAD with metabolic syndrome patients increased significantly (11.8% vs 10.0%, P=0.044). Fasting blood glucose (≥ 1000mg/L) and triglyceride (TG, ≥ 1500 mg/L) were responsible for most of the increased risk associated with the metabolic syndrome (adjusted OR 1.465, 95% CI 1.037-1.874, P=0.032; OR 1.378, 95% CI 1.014-1.768,P=0.044).Conclusions The prevalence of metabolic syndrome was very high in CAD patients. The metabolic syndrome confers a higher risk of long term MACCE in patients with CAD, and dysglycaemia and hypertriglycaemia appear to be responsible for most of the associated risk.关键词
coronary artery disease/revascularization/metabolic syndromeKey words
coronary artery disease/revascularization/metabolic syndrome分类
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HU Rong,JIA Chang-qi,LIU Xin-min,DONG Jian-zeng,LIU Xiao-hui,CHEN Fang,ZHOU Yu-jie,L(U) Shu-zheng,WU Xue-si,MA Chang-sheng,NIE Shao-ping,L(U) Qiang,KANG Jun-ping,DU Xin,ZHANG Yin,GAO Ying-chun,HE Li-qun..Effect of metabolic syndrome on prognosis and clinical characteristics of revascularization in patients with coronary artery disease[J].中华医学杂志（英文版）,2006,119(22):1871-1876,6.
