Cardiovasc Diabetol:纤维蛋白原对PCI治疗后的CAD患者的长期死亡率的预测价值

2021-07-23 Nebula MedSci原创

FIB与接受PCI的CAD患者的长期全因死亡率和心源性死亡率独立相关

纤维蛋白原 (FIB) 是普通人群死亡和血管事件的独立危险因素。但是,在接受经皮冠状动脉介入治疗 (PCI) 治疗的冠状动脉疾病 (CAD) 患者中,特别是在合并糖尿病 (DM) 或糖尿病前期 (Pre-DM)的,FIB与其长期死亡率之间的关系仍不明确。

本研究共纳入了6140位接受PCI的CAD患者,根据FIB水平将受试患者分成了三组:FIB-L、FIB-M和FIB-H (分别是低、中、高水平) 。并根据血糖状态(正常血糖[NG]、Pre-DM、DM)将这些患者进一步分组。主要终点是全因死亡率。次要终点是心源性死亡率。

各种分组患者的无全因死亡生存率

FIB与CAD患者的糖化血红蛋白(HbA1c)和空腹血糖(FBG)呈正相关,无论有无合并DM(p<0.001)。在中位随访5.1年期间(四分位范围 5.0-5.2年),FIB升高与长期死亡率(校正HR 1.86;95%CI 1.28-2.69;p=0.001)和心源性死亡率(1.82;1.15-2.89;p=0.011)显著相关。与此类似的,与血糖正常的患者组相比,合并DM的患者的全因死亡和心源性死亡风险均升高(p<0.05),但合并Pre-DM的患者的未见升高。

FIB水平和不同糖代谢水平患者的全因死亡率的相关性

当按FIB水平和血糖状态分组时,中高FIB水平的DM患者的死亡风险较高(校正HR分别是2.57和3.04;p<0.05)。值得注意的是,高FIB水平的糖尿病前期患者的死亡风险也较高(校正HR 2.27)。

综上所述,FIB与接受PCI的CAD患者的长期全因死亡率和心源性死亡率独立相关,特别是在合并DM和Pre-DM的患者中。FIB检测或有助于区分这类特殊人群中的高风险个体。

原始出处:

Yuan, D., Jiang, P., Zhu, P. et al. Prognostic value of fibrinogen in patients with coronary artery disease and prediabetes or diabetes following percutaneous coronary intervention: 5-year findings from a large cohort study. Cardiovasc Diabetol 20, 143 (2021). https://doi.org/10.1186/s12933-021-01335-1

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    2021-08-16 quxin068
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