JAHA:急性心肌梗死患者体重指数与心脏猝死

2018-07-08 xing.T MedSci原创

由此可见,肥胖(BMI≥27.5kg/ m2)与心肌梗死患者的SCD风险相关,尽管在全因死亡率方面存在肥胖悖论。

虽然心肌梗塞患者存在“肥胖悖论”,但探究肥胖与心源性猝死(SCD)风险之间关联的研究十分有限。近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,该研究的目的是确定肥胖是否与急性心肌梗死幸存者SCD风险增加有关。

研究人员合并了日本冠状动脉疾病(JCAD)和日本心脏病急性心肌梗死II期(HIJAMI-II)2项队列研究的数据,纳入了6216名出院的急性心肌梗死患者(平均年龄65±11岁,75.2%为男性)。根据世界卫生组织亚洲人群分类,患者根据基线体重指数(BMI)分为以下组别:BMI<18.5kg/m2(n=335)、18.5-23kg/m2(n=2371)、23-27.5kg/m2(n=2823)和≥27.5kg/m2(n=687)。该研究的主要结局为全因死亡率和SCD。

平均随访时间为3.6±1.4年,全因死亡率为10.1%,SCD发生率为1.2%。 BMI<18.5kg/m2的患者全因死亡率最高(校正风险比为1.61; 95%置信区间为1.20-2.16),但较高的BMI(≥27.5kg/m2)与死亡率无关,相比于BMI≥18.5kg/m2以及BMI<23kg/m2的患者。然而,在BMI≥27.5kg/m2的患者中,SCD的长期风险增加(校正风险比为2.97; 95%置信区间为1.24-7.15)。多变量分析显示,BMI≥27.5kg/m2与SCD风险增加有关(风险比为2.78; 95%置信区间为1.35-5.74)。

由此可见,肥胖(BMI≥27.5kg/ m2)与心肌梗死患者的SCD风险相关,尽管在全因死亡率方面存在肥胖悖论。

原始出处:

Tsuyoshi Shiga.et al. Body Mass Index and Sudden Cardiac Death in Japanese Patients After Acute Myocardial Infarction: Data From the JCAD Study and HIJAMI‐II Registry.JAHA.2018. https://doi.org/10.1161/JAHA.118.008633

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  1. [GetPortalCommentsPageByObjectIdResponse(id=331127, encodeId=423833112e83, content=学习!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7miblj4EHgFns3Mic85NWcRwwHYXCBDA8jW0GZ6iaZT55p0bicOcZXvsdT9henNafvCibicOUcwJtWUmkw/0, createdBy=a1fe1637734, createdName=wmw990556, createdTime=Thu Jul 12 19:22:50 CST 2018, time=2018-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=330931, encodeId=c2e433093105, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Wed Jul 11 22:45:18 CST 2018, time=2018-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=330828, encodeId=d0083308283d, content=急性心肌梗死的治疗., beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Wed Jul 11 12:35:00 CST 2018, time=2018-07-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267864, encodeId=d4ae126e8648a, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Tue Jul 10 02:19:00 CST 2018, time=2018-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=330318, encodeId=fde7330318ab, content=好文献学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b5a62240667, createdName=张新亮1853311252142e2fm, createdTime=Mon Jul 09 07:13:37 CST 2018, time=2018-07-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=330164, encodeId=727533016447, content=学习了.获益匪浅.感谢分享.收藏了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/02/27/c53a212859edcad4f60a54feffff50bb.jpg, createdBy=67cf1525321, createdName=13718711b3m, createdTime=Sun Jul 08 11:24:20 CST 2018, time=2018-07-08, status=1, ipAttribution=)]
    2018-07-12 wmw990556

    学习!!

    0

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    2018-07-11 惠映实验室

    学习了.谢谢分享.

    0

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    2018-07-11 jyzxjiangqin

    急性心肌梗死的治疗.

    0

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    2018-07-10 zhaohui6731
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    2018-07-09 张新亮1853311252142e2fm

    好文献学习了

    0

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    2018-07-08 13718711b3m

    学习了.获益匪浅.感谢分享.收藏了!

    0

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