三酰甘油葡萄糖指数与老年非介入治疗非ST段抬高型心肌梗死患者预后的关系研究

Study on relationship between triglyceride-glucose index and prognosis of elderly patients with non-ST-segment elevation myo-cardial infarction undergoing non-interventional therapy

中文关键词: 老年  三酰甘油葡萄糖指数  胰岛素抵抗  非ST段抬高型心肌梗死  预后

英文关键词: elderly  triglyceride-glucose index  insulin resistance  non-ST-segment elevation myocardial infarction  prog-nosis

中文摘要:

      目的 探讨三酰甘油葡萄糖(TyG)指数对老年非介入治疗非ST段抬高型心肌梗死(NSTEMI)患者预后的预测价值.方法 回顾性分析2018年7月—2022年6月,入住复旦大学附属华东医院心脏监护室,确诊为NSTEMI但未行介入治疗的80例老年患者临床资料.依据TyG中位数将患者分为低TyG组(n=40)和高TyG组(n=40).比较2组的一般资料,随访患者出院后的全因死亡情况.结果 80例老年NSTEMI患者年龄60～97岁,平均(80.8±9.4)岁,TyG指数中位数为8.70.与低TyG指数组相比,高TyG指数组患者年龄较小,体质量指数较高,饮酒史构成比较少,糖尿病构成比较多,总胆固醇、三酰甘油和空腹血糖水平较高,差异有统计学意义(P＜0.05).随访期间高TyG组患者死亡20例,低TyG组患者死亡13例.Kaplan-Meier生存分析显示,低TyG指数组预后优于高TyG指数组,差异有统计学意义(P=0.046).多因素Cox比例风险回归分析显示,TyG指数(HR=2.442,95％CI:1.449～4.117)、肌钙蛋白T峰值(HR=1.274,95％CI:1.037～1.565)、脑钠肽(HR=1.001,95％CI:1.000～1.001)升高和年龄(HR=1.050,95％CI:1.004～1.099)增大是影响非介入治疗老年NSTEMI患者生存率的独立预后因素.结论 低TyG指数的老年非介入治疗NSTEMI患者死亡风险可能低于高TyG指数者.

英文摘要:

      Objective To investigate the predictive value of the triglyceride-glucose(TyG)index for the prognosis of elderly patients with non-ST-segment elevation myocardial infarction(NSTEMI)undergoing non-interventional therapy.Methods The clinical data from 80 elderly patients diagnosed with NSTEMI and undergoing non-interventional therapy in Car-diac Care Unit of Huadong Hospital,Fudan University,between July 2018 and June 2022 were retrospectively analyzed.They were divided into low-TyG group(n=40)and high-TyG group(n=40)based on the median TyG index value.The general characteristics were compared between the two groups.All-cause mortality after discharge was followed up.Results The 80 elderly NSTEMI patients had an age range of 60 to 97 years(mean 80.8±9.4 years),with a median TyG index of 8.70.Compared with the low-TyG group,the high-TyG group had significantly younger age,higher body mass index(BMI),lower proportion of alcohol consumption history,higher proportion of diabetes mellitus,and higher levels of total cholesterol,triglyc-erides,and fasting blood glucose(all P＜0.05).During follow-up,20 patients died in the high-TyG group and 13 ones died in the low-TyG group.Kaplan-Meier survival analysis showed that the low-TyG group had a significantly better prognosis than the high-TyG group(P=0.046).Multivariate Cox proportional hazards regression analysis identified the increased TyG index(HR=2.442,95％CI:1.449-4.117),peak troponin T(HR=1.274,95％CI:1.037-1.565),B-type natriuretic peptide(BNP)(HR=1.001,95％CI:1.000-1.001),and advanced age(HR=1.050,95％CI:1.004-1.099)as independent prognostic factors affecting sur-vival in elderly NSTEMI patients undergoing non-interventional therapy.Conclusion Elderly NSTEMI patients undergoing non-interventional therapy with a lower TyG index may have a lower risk of mortality than those with a higher TyG index.