早发冠心病合并糖尿病患者药物洗脱支架置入术后早中期不良心血管事件分析

Early and intermediate follow-up study of premature coronary heart disease in patients with diabetes mellitus after drug-eluting stenting

目的探讨早发冠心病合并糖尿病患者药物洗脱支架(drug-eluting stent,DES)置入术后早中期的安全性及有效性。方法回顾性分析2009年1月-2011年12月在我院心内科行冠状动脉造影确诊为早发冠心病并行DES支架置入术的551例患者,根据是否合并糖尿病分为糖尿病组236例(随访228例,96.6%)、非糖尿病组315例(随访300例,95.3%),随访DES置入术后早中期的不良心血管事件(major adverse cardiac events,MACE)。结果早发冠心病合并糖尿病组中高血压(71.1%vs 59.3%,P=0.049)、女性(39.5%vs 26%,P=0.02)比例高于非糖尿病组,吸烟(33.3%vs 46%,P=0.038)比例小于非糖尿病组。糖尿病组MACE比例高于非糖尿病组,但差异无统计学意义(P>0.05)。结论 DES置入术后早发冠心病合并糖尿病患者与不合并糖尿病患者早中期MACE事件发生率相当,仍需大样本长期随访进一步研究。

Objective To explore the clinical risk factors in patients with premature coronary heart disease （PCHD） accompanying diabetes mellitus （DM） and investigate the early and intermediate effect and safety of implanted drug-eluting stents.Methods Five hundred andfifty-one patients who underwent drug-eluting stenting in our department from January 2009 to December 2012 were divided into PCHD with DM group （n=236） （follow-up 228, 96.6%） and PCHD without DM group （n=315） （follow-up 300, 95.3%） based on whether suffering from DM or not. The early and intermediate major adverse cardiac events （MACE） in patients after drug-eluting stenting were studied.Results The ratio of hypertension （71.1%vs 59.3%,P=0.049）, the proportion of female patients （39.5%vs 26%,P=0.02） and the average age （52.36±7.42 vs 50.29±6.84,P=0.02） in PCHD complicated with diabetes mellitus group were higher than non-diabetic group, smoking （33.3% vs 46%,P=0.038） ratio was less than non-diabetic group. Incidence of MACE had no statistical significance between the two groups （P〉0.05）, but the MACE incident rate were higher than non-diabetic group.Conclusion Comparing with non-diabetic patients, diabetic patients presenting with PCHD treated with DES have the same occurrence rate of MACE during short-term follow-up. Further large and multicenter follow-up studies are still required.