入院糖化血红蛋白对缺血性心力衰竭患者全因病死率的预后意义

Prognostic Implication of Admission Hemoglobin-A1c for All-cause Mortalityin Patients with Ischemic Heart Failure

目的研究缺血性心力衰竭(ischemic heart failure,IHF)患者入院时糖化血红蛋白(hemoglobin-A1c,HbA1c)与全因病死率的关系。方法选择2015年12月至2019年6月在广东省人民医院心内科住院符合入选条件的IHF患者,采用Kaplan-Meier生存分析和Cox回归分析,探讨入院时HbA1c与IHF全因病死率的关系。结果本研究的1413例受试者的年龄为(63.2±10.9)岁,男性占85%,入院时HbA1c浓度为6.82%。与HbA1c≤7%组相比,HbA1c>7%组患者全因病死率升高(HR=1.328,95%CI:1.016~1.735,P=0.037)。男性和年轻人群中,入院时HbA1c和全因病死率之间的关联也具有统计学意义。结论入院时HbA1c浓度升高(>7%)是IHF患者全因死亡的独立危险因素,在男性和年轻人群中也有一致的趋势。

Objectives To investigated the association between admission hemoglobin-A1c(HbA1c)and all-cause mortality in a Chinese population with ischemic heart failure(IHF).Methods Eligible patients with IHF at the Department of Cardiology,Guangdong Provincial People's Hospital from December 2015 to June 2019 were enrolled to investigate the association between admission HbA1c and all-cause mortality of IHF with Kaplan-Meier survival analysis and Cox regression analysis.Results Of 1413 participants,the median age was(63.2±10.9)years,85%were men and median admission concentration of HbA1c was 6.82%.All-cause mortality was higher in HbA1c>7%group compared with HbA1c≤7%group[hazard ratio(HR)=1.328,95%confidence interval(CI):1.016-1.735,P=0.037].The association between HbA1c and all-cause mortality was also statistically significant in the male and younger cohorts.Conclusions Elevated admission HbA1c level(>7%)is an independent risk factor for all-cause mortality of IHF in the general population,and there is also a consistent trend among male and younger individuals.