摘要
目的探讨甘油三酯葡萄糖乘积(TyG)指数联合SYNTAX积分对急性冠状动脉综合征(ACS)患者的心血管事件影响。方法连续入选2017年9月至2019年9月就诊于我院心脏中心的ACS患者978例,根据入院时计算TyG指数分为4组:第一组(C1组,TyG≤8.691)200例;第二组(C_(2)组,TyG 8.692~9.097)236例;第三组(C_(3)组,TyG 9.098~9.607)265例;第四组(C_(4)组,TyG≥9.608)277例,对比分析各组临床特点以及冠状动脉血管情况,并随访2年记录主要终点事件为主要不良心血管事件(MACE)。结果4组女性、糖尿病、脑卒中、心率、收缩压、舒张压、白细胞计数、空腹血糖、糖化血红蛋白、血脂、B型钠尿肽、SYNTAX积分及使用他汀类药物比例比较,差异有统计学意义(P<0.05,P<0.01)。TyG指数联合SYNTAX积分的ROC曲线下面积高于TyG指数、SYNTAX积分单独预测(P<0.05)。Cox分析SYNTAX积分(95%CI:1.083~1.103,P<0.01)及TyG(95%CI:1.231~4.155,P<0.01)是MACE的独立危险因素,C_(1)组生存率明显高于C_(2)组、C_(3)组以及C_(4)组,而C4组较其他3组的生存率明显降低(P<0.05)。结论TyG指数联合SYNTAX积分对ACS患者更有利于判断长期预后价值。
Objective To investigate the impact of TyG index and SYNTAX score on cardiovascular events in ACS patients.Methods A total of 978 ACS patients admitted to our heart center between September 2017 and September 2019 were consecutively enrolled in this study.According to TyG index,they were divided into groups C_(1)~C_(4),with the index level of≤8.691(200 cases),8.692~9.097(236 cases),9.098~9.607(265 cases)and≥9.608(277 cases),respectively.Clinical characteristics and coronary arterises were compared among the 4 groups of patients.The incidence of MACE,as primary endpoint was observed during the 2 years'follow-up.Results Significant differences were found in gender,diabetes,history of stroke,heart rate,SBP,DBP,white blood cell count,blood glucose,glycosylated hemoglobin,blood lipids,BNP,SYNTAX score and statin usage among the 4 groups(P<0.05,P<0.01).The AUC value of TyG index combined with SYNTAX score was higher than that of the 2 indicators alone in prediction of MACE(P<0.05).SYNTAX score(95%CI:1.083-1.103,P<0.01)and TyG index(95%CI:1.231-4.155,P<0.01)were independent risk factors for MACE.The survival rate of patients of group C_(1)were higher than the other 3 groups of patients;while the survival rate of group C_(4)was significantly lower(P<0.05).Conclusion TyG index combined with SYNTAX score is more helpful for predicting long-term prognosis of ACS patients.
作者
王建龙
刘博江
王赟赟
赖朝辉
刘迎午
Wang Jianlong;Liu Bojiang;Wang Yunyun;Lai Chaohui;Liu Yingwu(Heart Center,Tianjin Third Central Hospital,Tianjin 300170,China)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2023年第8期827-831,共5页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
天津市卫生健康科技项目(ZC20226)。
