Zhonghua nei ke za zhi · 2012
[The association of insulin resistance, blood pressure variability and severity of acute coronary syndrome].
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Li Shao-nan, Luo Yi, Li Guang-lian, Huang Hui-fang, Chen Ping-an, Liu Zhen
Аннотация
OBJECTIVE: To investigate the association of insulin resistance (IR), blood pressure variability (BPV) and the severity of acute coronary syndrome (ACS), and assess the effect of percutaneous coronary intervention (PCI) on recent prognosis.
METHODS: A total of 260 patients diagnosed as ACS and hospitalized in our department of cardiology from December 2009 to December 2010 were enrolled in the study. There were 93 cases of unstable angina pectoris(UAP), 84 of non ST segment elevation myocardial infarction and 83 of unstable angina pectoris. The subjects were divided into two groups according to 24 hour systolic blood pressure coefficient of variability (24 h SBP-CV) levels: high-CV group (24 h SBP-CV > 11.5, n = 130) and low-CV group(24 h SBP-CV < 11.5, n = 130). The differences in HOMA-IR and the severity of coronary artery diseases between the two groups were compared. The association of major adverse cardiac events within 6 months after PCI treatment, and IR as well as BPV was analyzed.
RESULTS: Compared with the low-CV group, ACS patients in the high-CV group had obviously higher HOMA-IR levels (5.7 ± 1.2 vs 4.0 ± 1.4, P < 0.01), more multivessel diseases (49.2% vs 33.3%, P < 0.05) and B2/C type coronary diseases (48.5% vs 27.7%, P < 0.01), and higher coronary Gensini scores (59.7 ± 17.5 vs 43.8 ± 18.6, P < 0.01). Multi-factors logistic regression analysis indicated that both 24 h BPV-CV and IR were independent predictors for MACE incidence within 6 months after undergone PCI (P < 0.05 or P < 0.01).
CONCLUSIONS: IR and BPV were obviously associated with the severity of coronary artery diseases in ACS patients. IR and 24 h BPV-CV were valuable in predicting recent prognosis of ACS patients.
METHODS: A total of 260 patients diagnosed as ACS and hospitalized in our department of cardiology from December 2009 to December 2010 were enrolled in the study. There were 93 cases of unstable angina pectoris(UAP), 84 of non ST segment elevation myocardial infarction and 83 of unstable angina pectoris. The subjects were divided into two groups according to 24 hour systolic blood pressure coefficient of variability (24 h SBP-CV) levels: high-CV group (24 h SBP-CV > 11.5, n = 130) and low-CV group(24 h SBP-CV < 11.5, n = 130). The differences in HOMA-IR and the severity of coronary artery diseases between the two groups were compared. The association of major adverse cardiac events within 6 months after PCI treatment, and IR as well as BPV was analyzed.
RESULTS: Compared with the low-CV group, ACS patients in the high-CV group had obviously higher HOMA-IR levels (5.7 ± 1.2 vs 4.0 ± 1.4, P < 0.01), more multivessel diseases (49.2% vs 33.3%, P < 0.05) and B2/C type coronary diseases (48.5% vs 27.7%, P < 0.01), and higher coronary Gensini scores (59.7 ± 17.5 vs 43.8 ± 18.6, P < 0.01). Multi-factors logistic regression analysis indicated that both 24 h BPV-CV and IR were independent predictors for MACE incidence within 6 months after undergone PCI (P < 0.05 or P < 0.01).
CONCLUSIONS: IR and BPV were obviously associated with the severity of coronary artery diseases in ACS patients. IR and 24 h BPV-CV were valuable in predicting recent prognosis of ACS patients.