Objective:To analyze the clinical characteristics of patients with type 2 diabetes mellitus(T2DM)with acute coronary syndrome(ACS),the global registry of acute coronary events(GRACE)score,the thrombolysis in myocardia...Objective:To analyze the clinical characteristics of patients with type 2 diabetes mellitus(T2DM)with acute coronary syndrome(ACS),the global registry of acute coronary events(GRACE)score,the thrombolysis in myocardial infarction(TIMI)score and clinical prognosis.Method:The study was a retrospective one-center observational study,continuous inclusion of 600 ACS patients diagnosed by coronary angiography in our hospital from October 2018 to July 2019.Collect general clinical data,laboratory examination results,imaging data and interventional treatment data of all patients.Were divided into:T2DM with ACS group(group DA)and non-T2DM with ACS(group NDA)according to whether or not they were associated with T2DM.According to the GRACE、TIMI score,the two groups were divided into high risk group,middle risk group and low risk group.All patients underwent coronary angiography to calculate the number of vascular lesions and Gensini scores.Design questionnaire,after discharge to 2 groups of patients by telephone or outpatient follow-up average of 10 months,statistics of the occurrence of MACE events.Result:Among the 600 patients included in the study,362 were male(60.3%)and 238 were female(39.7%)with mean age(64.7±10.3)years.The baseline data showed that the G、TG、UA、CR levels were higher in the DA group than in the NDA group;the proportion of men was lower than in the NDA group.The results of coronary angiography showed that the Gensini score of DA group was higher than that of NDA group,and the proportion of single lesion was lower than that of NDA group.The binary Logistic regression analysis suggested that age and CRP were independent risk factors for MACE events in patients with T2DM.GRACE risk stratification showed that the proportion of high risk group in DA group was significantly higher than that in NDA group,and there was no significant difference between low and middle risk group.TIMI risk stratification showed that the proportion of high risk group in DA group was significantly higher than that in NDA group,while the proportion of low and middle risk group was lower than that in NDA group.The ROC curve shows that the area(AUC)below the ROC curve that GRACE、TIMI score predicted the occurrence of MACE events in patients with T2DM and ACS was 0.707 and 0.586.Conclusion:Patients with T2DM and ACS had higher clinical risk stratification than without T2DM.GRACE score compared with the TIMI score had better predictive value for the occurrence of MACE events after discharge of T2DM with ACS patients.展开更多
Background： In cardiology, it is controversial whether different therapy strategies influence prognosis after acute coronary syndrome. We examined and compared the long-term outcomes of invasive and conservative stra...Background： In cardiology, it is controversial whether different therapy strategies influence prognosis after acute coronary syndrome. We examined and compared the long-term outcomes of invasive and conservative strategies in patients with non-ST-segment elevation myocardial infarction （NSTEMI） and characterized the patients selected for an invasive approach. Methods： A total of 976 patients with acute NSTEMI were collected from December 2006 to October 2012 in the First Affiliated Hospital of Dalian Medical University Hospital. They are divided into conservative strategy （586 patients） and invasive strategy （390 patients） group. Unified tbllow-up questionnaire was performed by telephone contact （cut-off date was November, 2013）. The long-term clinical events were analyzed and related to the different treatment strategies. Results： The median follow-up time was 29 months. Mortality was 28.7% （n = 168） in the conservative group and 2.1% （n = 8） in the invasive management at long-term clinical follow-up. The secondary endpoint （the composite endpoint） was 59.0% （n = 346） in the conservative group and 30.3% （n = 118） in the invasive management. Multivariate analysis showed that patients in the conservative group had higher all-cause mortality rates than those who had the invasive management （adjusted risk ratio [RR] = 7.795; 95% confidence interval [CI]： 3.796 16.006, P 〈 0.001）, and the similar result was also seen in tile secondary endpoint （adjusted RR ： 2.102; 95% （7： 1.694-2.610, P 〈 0.001 ）. In the subgroup analysis according to each Thrombolysis in Myocardial Infarction risk score （TRS）, log-rank analysis showed lower mortality and secondary endpoint rates in the invasive group with the intermediate and high-risk patients （TRS 3-7）. Conclusions： An invasive strategy could improve long-term outcomes for NSTEMI patients, especially for intermediate and high-risk ones （TRS 3- 7）.展开更多
基金512 Talent Culture Planning(No.by51201317,by51201105)Innovation Team of Basic and Clinical Application for Cardiovascular Injury and Protection(No.BYKC201906)+1 种基金Technology and Science Innovation Team of Bengbu Medical College(No.BYJC201901)Natural Science Research Key Programm of Bengbu Medical College(No.2020byzd109)。
文摘Objective:To analyze the clinical characteristics of patients with type 2 diabetes mellitus(T2DM)with acute coronary syndrome(ACS),the global registry of acute coronary events(GRACE)score,the thrombolysis in myocardial infarction(TIMI)score and clinical prognosis.Method:The study was a retrospective one-center observational study,continuous inclusion of 600 ACS patients diagnosed by coronary angiography in our hospital from October 2018 to July 2019.Collect general clinical data,laboratory examination results,imaging data and interventional treatment data of all patients.Were divided into:T2DM with ACS group(group DA)and non-T2DM with ACS(group NDA)according to whether or not they were associated with T2DM.According to the GRACE、TIMI score,the two groups were divided into high risk group,middle risk group and low risk group.All patients underwent coronary angiography to calculate the number of vascular lesions and Gensini scores.Design questionnaire,after discharge to 2 groups of patients by telephone or outpatient follow-up average of 10 months,statistics of the occurrence of MACE events.Result:Among the 600 patients included in the study,362 were male(60.3%)and 238 were female(39.7%)with mean age(64.7±10.3)years.The baseline data showed that the G、TG、UA、CR levels were higher in the DA group than in the NDA group;the proportion of men was lower than in the NDA group.The results of coronary angiography showed that the Gensini score of DA group was higher than that of NDA group,and the proportion of single lesion was lower than that of NDA group.The binary Logistic regression analysis suggested that age and CRP were independent risk factors for MACE events in patients with T2DM.GRACE risk stratification showed that the proportion of high risk group in DA group was significantly higher than that in NDA group,and there was no significant difference between low and middle risk group.TIMI risk stratification showed that the proportion of high risk group in DA group was significantly higher than that in NDA group,while the proportion of low and middle risk group was lower than that in NDA group.The ROC curve shows that the area(AUC)below the ROC curve that GRACE、TIMI score predicted the occurrence of MACE events in patients with T2DM and ACS was 0.707 and 0.586.Conclusion:Patients with T2DM and ACS had higher clinical risk stratification than without T2DM.GRACE score compared with the TIMI score had better predictive value for the occurrence of MACE events after discharge of T2DM with ACS patients.
文摘Background： In cardiology, it is controversial whether different therapy strategies influence prognosis after acute coronary syndrome. We examined and compared the long-term outcomes of invasive and conservative strategies in patients with non-ST-segment elevation myocardial infarction （NSTEMI） and characterized the patients selected for an invasive approach. Methods： A total of 976 patients with acute NSTEMI were collected from December 2006 to October 2012 in the First Affiliated Hospital of Dalian Medical University Hospital. They are divided into conservative strategy （586 patients） and invasive strategy （390 patients） group. Unified tbllow-up questionnaire was performed by telephone contact （cut-off date was November, 2013）. The long-term clinical events were analyzed and related to the different treatment strategies. Results： The median follow-up time was 29 months. Mortality was 28.7% （n = 168） in the conservative group and 2.1% （n = 8） in the invasive management at long-term clinical follow-up. The secondary endpoint （the composite endpoint） was 59.0% （n = 346） in the conservative group and 30.3% （n = 118） in the invasive management. Multivariate analysis showed that patients in the conservative group had higher all-cause mortality rates than those who had the invasive management （adjusted risk ratio [RR] = 7.795; 95% confidence interval [CI]： 3.796 16.006, P 〈 0.001）, and the similar result was also seen in tile secondary endpoint （adjusted RR ： 2.102; 95% （7： 1.694-2.610, P 〈 0.001 ）. In the subgroup analysis according to each Thrombolysis in Myocardial Infarction risk score （TRS）, log-rank analysis showed lower mortality and secondary endpoint rates in the invasive group with the intermediate and high-risk patients （TRS 3-7）. Conclusions： An invasive strategy could improve long-term outcomes for NSTEMI patients, especially for intermediate and high-risk ones （TRS 3- 7）.
