峰值摄氧量对中国冠状动脉粥样硬化性心脏病患者不良预后的预测价值

Prognostic Value of Peak Oxygen Consumption for Adverse Outcomes in Chinese People with Coronary Artery Disease

目的探究峰值摄氧量(peak oxygen consumption,Peak VO_(2))对中国冠状动脉粥样硬化性心脏病(coronary artery disease,CAD)人群不良预后风险的预测价值。方法纳入2013年1月至2022年4月在广东省人民医院就诊并完成心肺运动试验(cardiopulmonary exercise test,CPET)的CAD患者并按Peak VO_(2)四分位间距分成Q1~Q4组,使用多因素Cox回归进行风险分析,描绘限制立方样条图(restricted cubic spline,RCS)评估Peak VO_(2)与不良预后关系的整体趋势。结果最终纳入635例患者,年龄为(59.57±11.09)岁,Peak VO_(2)为(19.66±5.38)mL·kg^(-1)·min^(-1),在大约3.4年内,发生了2.5%的全因死亡、1.9%的心血管疾病死亡及14.5%的重大主要不良心血管事件(major adverse cardiovascular events,MACE)。Q4、Q3和Q2组的3类风险均比Q1更低。RCS曲线显示,随着Peak VO_(2)从低到高,全因死亡风险先是大幅度下降而后趋于平稳。结论Peak VO_(2)对中国CAD人群不良预后具有较好的预测价值。

Objectives To investigate the prognostic value of peak oxygen consumption(Peak VO_(2))for adverse outcomes in the Chinese coronary artery disease(CAD)population.Methods The study included CAD patients who underwent cardiopulmonary exercise tests(CPET)at Guangdong Provincial People's Hospital from January 2013 to April 2022.Patients were categorized into Q1-Q4 groups based on the quartile range of Peak VO_(2),and a multivariate Cox regression was employed for risk analysis.Restricted cubic spline(RCS)plots were used to assess the overall trend of the relationship between Peak VO_(2) and adverse outcomes.Results A total of 635 patients were included,with an average age of(59.57±11.09)years and a mean Peak VO_(2) of(19.66±5.38)mL·kg^(-1)·min^(-1).Over approximately 3.4 years,there were 2.5% all-cause mortality,1.9% cardiovascular disease mortality,and 14.5% major adverse cardiovascular events(MACE).The three risk categories of Q4,Q3,Q2 demonstrated lower risks compared to Q1.RCS curves indicated a substantial initial decrease followed by a stabilization in the risk of all-cause mortality as Peak VO_(2) increased.Conclusions Peak VO_(2) has significant predictive value for adverse outcomes in Chinese CAD population.