没有传统心血管危险因素的CAD患者TyG指数与冠脉损伤和一年再入院的关系  

Association of TyG index with coronary artery lesions and one-year readmission in coronary artery disease patients without traditional cardiovascular risk factors

作　　者：栾慧 王萍[1] 曹丽菲 罗超迪 郑婷婷 白川[2] 朱丹军[1] 田刚[1] LUAN Hui;WANG Ping;CAO Li-fei;LUO Chao-di;ZHENG Ting-ting;BAI Chuan;ZHU Dan-jun;TIAN Gang(Department of Cardiology,First Affiliated Hospital,Xi’an Jiao Tong University,Xi’an 710061,Shaanxi,China;Interventional Operating Room,First Affiliated Hospital,Xi’an Jiao Tong University,Xi’an 710061,Shaanxi,China)

机构地区：[1]西安交通大学第一附属医院心内科,陕西西安710061 [2]西安交通大学第一附属医院介入手术室,陕西西安710061

出　　处：《心脏杂志》2022年第2期135-140,共6页Chinese Heart Journal

基　　金：国家自然科学基金项目资助(81873513,81600574,30871042);陕西省科学技术研究发展计划重点项目资助(2018ZDXM-SF-049);西安交通大学第一附属医院临床研究重点项目资助(XJTU1AF-CRF-2018-005);陕西省科学技术研究发展计划国际科技合作与交流计划项目资助(2012 kw-40-01);陕西省科学技术研究发展计划自然科学基础研究计划项目资助(2014 JM2-8145)。

摘　　要：目的探讨没有传统心血管危险因素(CVRF)的冠心病(coronary artery disease,CAD)患者甘油三酯葡萄糖(triglyceride glucose,TyG)指数与冠脉损伤及一年再入院的关系。方法共分析了300例(60±92)岁(男,71.3%)无传统CVRF的冠心病患者,CVRF(传统标准):收缩压/舒张压≥140/90mmHg;空腹血糖≥1260mg/L;总胆固醇≥2400 mg/L;低密度脂蛋白胆固醇≥1600 mg/L;高密度脂蛋白胆固醇<400 mg/L;体质量指数≥24.0 kg/m^(2);吸烟;既往有高血压、糖尿病和血脂异常病史。根据其TyG指数三分位数分为三组,横向对比了三组患者冠状动脉造影特征以及严重冠心病患病风险,并前瞻性地探讨了TyG指数与一年再入院发生的关系。结果在没有传统CVRF的冠心病患者中,随着TyG指数的分位数增加,冠脉病变形态除了弥漫病变患病率没有趋势变化,左主干病变、三支病变、钙化病变、完全闭塞病变等复杂病变患病率逐渐增高,相邻组间统计学差异P<0.05,跨组统计学差异P<0.01。三组之间Gensini评分的差异具有统计学意义,随着TyG指数的分位数增加Gensini评分逐渐增高[39(20,59)vs.47(18,72)vs.51(20,109)],相邻组间统计学差异P<0.05,跨组统计学差异P<0.01。以T1组作为参照,处于T3组的无传统CVRF的CAD患者患严重冠心病风险增加(OR=2.62),校正潜在心血管危险因素后,风险依然存在,差异具有统计学意义(均P<0.05)。前瞻性分析表明,随着TyG指数的分位数增加,一年再入院率增加(HR:2.57,95%CI:1.13~5.78)。在控制其他风险因素后,处于T3组的无传统CVRF的CAD患者一年再入院发生风险是处于T1组的无传统CVRF的CAD患者的近3倍。结论在无传统CVRF的CAD患者中TyG指数水平升高的患者冠状动脉病变更严重,一年再入院的风险增加。AIM To explore the association of triglyceride glucose(TyG)with the severity of cardiovascular diseases and one-year re-admission rate in coronary artery disease(CAD)patients without traditional cardiovascular risk factors(CVRFs).METHODS The data of 300 CAD patients without CVRFs(60±9 years,71.3%male)were analyzed.The following were considered as traditional CVRFs:systolic/diastolic blood pressure≥140/90 mmHg;fasting glucose≥1260 mg/L;total cholesterol≥2400 mg/L;low-density lipoprotein cholesterol(LDL-C)≥1600 mg/L;high-density lipoprotein cholesterol<4000 mg/dL;body mass index≥24.0 kg/m^(2);current smoking status;and previous medical history of hypertension,diabetes and dyslipidaemia.The subjects were assigned to three groups based on their TyG index tertiles.Their coronary angiography characteristics were analyzed in a cross-sectional study and the relationship between TyG index and one-year re-admission rate was prospectively explored.RESULTS The cross-sectional analysis showed that in CAD patients without traditional CVRFs,the incidence of left main disease,three-vessel disease,calcification lesion,total occlusive lesion and complex lesion,as well as Gensini score was in the order of TyG index tertile 3>TyG index tertile 2>TyG index tertile.The statistical difference between adjacent groups was P<0.05,and the cross group statistical difference was P<0.01.In addition,CAD patients without traditional CVRFs in the highest TyG index tertile group were at an increased risk of severe CAD(OR=2.62)and the correlation was still statistically significant even after adjusting for potential cardiovascular risk factors,The statistical difference between adjacent groups was P<0.05,and the cross group statistical difference was P<0.01.Prospective analyses showed that the higher the TyG index tertile was,the higher the one-year readmission rate in CAD patients without traditional CVRFs.After adjusting for other risk factors,the oneyear re-admission rate of patients in the highest TyG index tertile group was nearly

关 键 词：传统心血管危险因素 甘油三酯葡萄糖指数 冠脉损伤 一年再入院 

分 类 号：R541.4[医药卫生—心血管疾病]