目的 基于倾向评分匹配方法(PSM),探究三酰甘油-葡萄糖(TyG)指数与急性心肌梗死(AMI)患者院内不良心血管事件(MACE)的关联。方法 回顾性分析2022-01至2024-05解放军总医院第一医学中心收治的AMI患者769例,根据是否发生MACE分为非MACE组和MACE组。采用PSM进行1∶1匹配,均衡两组的基线资料,比较匹配后两组的临床资料,并采用多因素Logistic回归分析TyG指数与AMI患者院内MACE之间的关系。结果 769例中有132例发生院内MACE。PSM前,两组患者年龄、吸烟史、饮酒史、糖尿病史及卒中史具有统计学差异(P<0.05),PSM后得到258例样本,组间比较均衡;PSM后,MACE组心率、C-反应蛋白(CRP)、脑利钠肽前体(NT-proBNP)、TyG指数水平及肾功能不全、肝功能不全、主动脉内球囊反搏(IABP)、体外膜肺氧合(ECMO)比例较高,而收缩压(SBP)、血红蛋白(Hb)、白蛋白水平及临时起搏器使用比例较低(P<0.05);多因素Logistic回归分析表明,在调整混杂因素后,TyG指数[OR及95%CI:1.96(1.23~3.13)]仍然是院内MACE的影响因素(P<0.05)。结论 AMI患者院内MACE发生率随TyG指数升高而增高,TyG指数是前者的独立影响因素。
Abstract
Objective To investigate the association between the triglyceride-glucose(TyG) index and in-hospital major adverse cardiovascular events(MACE) in patients with acute myocardial infarction(AMI) based on propensity score matching (PSM) method. Methods A retrospective analysis was conducted on 769 AMI patients admitted to the First Medical Center of PLA General Hospital from January 2022 to May 2024. The patients were divided into non-MACE and MACE groups based on the occurrence of MACE. PSM was used for 1:1 matching to balance the baseline data between the two groups. Clinical data after matching were compared, and the relationship between the TyG index and in-hospital MACE in AMI patients was analyzed using multivariable logistic regression. Results A total of 132 patients experienced in-hospital MACE. Before PSM, there were significant differences in age, smoking history, drinking history, diabetes history, and stroke history between the two groups (P<0.05). After PSM, 258 cases were obtained, and the comparison between the groups was balanced. After PSM, the MACE group had higher levels of heart rate, C-reactive protein (CRP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), TyG index, and higher proportions of renal dysfunction, liver dysfunction, intra-aortic balloon pumping(IABP), and extracorporeal membrane oxygenation (ECMO), while the systolic blood pressure(SBP), hemoglobin(Hb), albumin levels, and the proportion of temporary pacemaker use were lower (P<0.05). Multivariable logistic regression analysis showed that after adjusting for confounding factors, TyG index [OR and 95% CI: 1.96(1.23-3.13)] was still the influential factor for MACE in hospital (P<0.05). Conclusions The incidence of in-hospital MACE of AMI patients increases with the elevation of the TyG index, and the TyG index is an independent influencing factor of the former.
关键词
三酰甘油-葡萄糖指数 /
急性心肌梗死 /
院内不良心血管事件
Key words
triglyceride-glucose index /
acute myocardial infarction /
in-hospital adverse outcome
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