摘要
目的探讨心外膜脂肪厚度(EAT)与急性冠状动脉综合征(ACS)再发不良心血管事件(MACE)的关系。方法选取衡水市人民医院在2020年1月至2020年6月确诊并治疗的190例ACS患者作为研究对象。行经胸超声心动图测量患者的EAT水平。对患者实施临床随访,主要终点为再发MACE事件。观察比较MACE组及非MACE组的临床特征,并通过多因素分析确定ACS患者再发MACE事件的危险因素。绘制了受试者操作特征(ROC)曲线评估EAT水平预测MACE事件的能力。结果分析纳入的190名ACS患者中,平均EAT为4.6 mm。并发现ACS患者的EAT厚度与BMI呈正相关;与LVEF呈负相关(P<0.05)。随访12个月共发生了40例MACE:4例猝死,22例ACS、9例需要血运重建和5例心力衰竭。根据临床随访结果是否发生MACE事件进一步分组分析显示两组年龄,糖尿病发生率、BMI指标以及EAT值比较,差异有统计学意义(P<0.05)。两组在TC、TG、LDH⁃C、HDL⁃C、hs⁃CRP、高血压、吸烟、LVEF(%)、E/A、E/Ea、单支病变、多支病变比较差异无统计学意义(P>0.05)。多因素logistic回归模型显示,EAT和糖尿病为ACS患者再发MACE事件的独立危险因素(P<0.05)。ROC曲线分析结果表明,当EAT截止值为5 mm时,具有较高的区分MACE的诊断性能,灵敏度:0.91,特异度:0.72,AUC为0.84(95%CI:0.74~0.91,P<0.05)。结论ACS患者MACE事件的再发和EAT水平有良好的相关性,可作为临床ACS事件发生的预测因子。在提前识别高危ACS患者及指导进一步治疗具有一定的临床意义。
Objective To explore the relationship between epicardial adipose thickness(EAT) and recurrent adverse cardiovascular events(MACE)in acute coronary syndrome(ACS). Methods 190ACS patients diagnosed and treated in our hospital from January 2020 to June 2020 were selected as the research objects. Transthoracic echocardiography was performed to measure the patient ’ s EAT level. The clinical follow-up of the patients was carried out,and the primary endpoint was a recurring MACE event. The clinical characteristics of MACE group and non-MACE group were observed and compared,and independent risk factors for recurrent MACE events in ACS patients were determined through a multivariate logistic regression model. A receiver operating characteristic(ROC)curve was drawn to evaluate the ability of EAT to predict MACE events. Results Among the 190 ACS patients included in the analysis,the mean EAT was 4.6 mm. A total of 40 patients with MACE were followed up for 12 months. It was found that the thickness of EAT in ACS patients was good correlated with BMI. It was negatively correlated with LVEF(P<0.05). A total of 40MACE patients occurred during the 12-month follow-up: 4 sudden death, 22 ACS, 9 requiring revascularization,and 5 heart failure. According to clinical follow-up results whether MACE events occurred,further grouping analysis showed that there were statistically significant differences between the two groups in older age,presence of diabetes,BMI and EAT(P<0.05). There was no significant difference between the two groups in TC,TG,LDH-C,HDL-C,hs-CRP,hypertension,smoking,LVEF(%),E/A,E/Ea,single-vessel disease,and multi-vessel disease(P>0.05). Multivariate logistic regression model showed that EAT and diabetes were independent risk factors for recurrent MACE events in ACS patients(P<0.05). The results of ROC curve analysis showed that when the EAT cutoff value was 5 mm,it had a high diagnostic performance for distinguishing MACE,with a sensitivity of 0.91,a specificity of 0.72,and an AUC of 0.84(95%CI:0.74~0.91,P<0.05). Conclusion The recurrence of MACE events in patients with ACS has a good correlation with EAT level,which can be used as a predictor of clinical ACS events. It has certain clinical significance in identifying high-risk ACS patients in advance and guiding further treatment.
作者
肖建东
路玉李
王雅
马星
XIAO Jiandong;LU Yuli;WANG Ya;MA Xing(Department of Cardiology,Hengshui People's Hospital,Hengshui,Hebei,China,053000;Department of Endocrinology,Hengshui People's Hospital,Hengshui,Hebei,China,053000;Department of Ultrasound,Hengshui People's Hospital,Hengshui,Hebei,China,053000)
出处
《分子诊断与治疗杂志》
2022年第5期828-831,共4页
Journal of Molecular Diagnostics and Therapy
基金
衡水市科学技术研究与发展计划项目(2019014053Z)。
关键词
心外膜脂肪厚度
急性冠脉综合征
心血管事件
经胸超声心动图
Epicardial adipose thickness
Acute coronary syndrome
Adverse cardiovascular events
Transthoracic echocardiography
