新型人体测量学指标与急性心肌梗死患者长期预后的相关性

doi:10.3969/j.issn.1006-5725.2024.21.013

Abstract

Abstract:

Objective To explore the predictive value of novel anthropometric indicators for the long-term prognosis in patients with acute myocardial infarction （AMI）. Methods A total of 712 patients diagnosed with AMI in the People's Hospital of Xinjiang Uygur Autonomous Region from January 2018 to December 2019 were selected as research subjects， and divided into an event group and a non-event group according to whether major cardiovascular adverse events （MACEs） occurred during the period of follow-up. Gensini score was used to quantitatively assess the degree of coronary artery stenosis. Spearman correlation analysis was used to explore the correlation between the new anthropometric indicators and Gensini score. Receiver operating characteristic （ROC） curve was used to evaluate the ability of new anthropometric indicators to predict MACEs， and the patients were grouped according to the optimal cut-off value. Kaplan-Meier curve was used to analyze the survival difference between the groups. Multivariate Cox regression was used to analyze the independent risk factors of MACEs. Results During a median follow-up of 27（20，39）months， a total of 125 patients developed MACEs. As compared with those in the non-event group， the patients in the event group had a higher proportion of hypertension， diabetes and abdominal obesity， higher HbA1c and FBG levels， and longer body weight and waist circumference. The LAP index， CMI index， BRI index and Gensini score were significantly increased， and the differences were statistically significant （P ? 0.05）. Spearman correlation analysis showed that LAP index， CMI index and BRI index were positively correlated with Gensini score （r = 0.233， 0.126， 0.272， P < 0.001）. ROC curve analysis showed that the AUC of LAP index， CMI index， VAI index， BRI index and ABSI index were 0.745， 0.640， 0.490， 0.874 and 0.506 respectively； Kaplan-Meier curve analysis showed that the cumulative incidence of MACEs in LAP index， CMI index and BRI index was significantly increased in the high-value group （Log-rank test， P ? 0.05）. The results of multivariate Cox regression analysis after adjusting confounding showed that CMI index （HR = 1.430， 95%CI： 1.049 ~ 1.952， P = 0.024） and BRI index （HR = 1.332， 95%CI： 1.234 ~ 1.439， P ? 0.001）were independent risk factors for MACEs. Conclusions CMI index and BRI index of new anthropometric indicators are independent risk factors for long-term prognosis in patients with AMI.

Key words: new anthropometric indicators, visceral obesity, acute myocardial infarction, Gensini score, prognosis

CLC Number:

R542.22

Kaiyang WANG,Jing TAO,Tingting WU,Jiahui YONG,Guoqing LI,Xiang XIE,Yining. YANG. Correlation of novel anthropometric indicators with long⁃term prognosis in patients with acute myocardial infarction[J]. The Journal of Practical Medicine, 2024, 40(21): 3040-3046.

Figures/Tables 5

Tab.1

Baseline characteristics of the two groups"

临床资料	事件组（n = 125）	非事件组（n = 587）	U/χ²值	P值
年龄/岁	61（54，70）	60（51，68）	-1.688	0.091
男性/［例（%）］	41（32.8）	154（26.24）	1.915	0.166
高血压/［例（%）］	89（71.2）	322（54.86）	10.622	0.001
糖尿病/［例（%）］	67（53.6）	217（36.97）	11.206	< 0.001
血脂异常/［例（%）］	122（97.6）	545（92.84）	3.173	0.075
腹型肥胖/［例（%）］	64（51.2）	219（37.31）	7.734	0.005
吸烟史/［例（%）］	38（30.4）	228（38.84）	2.788	0.095
RBC/（×10¹²/L）	4.53（4.08，4.91）	4.56（4.2，4.91）	0.718	0.473
WBC/（×10⁹/L）	7.2（6.2，8.9）	7.03（5.81，8.4）	-1.344	0.179
NE/%	62.4（56.1，69.1）	61.2（54.7，66.8）	-1.602	0.109
LY/%	27.7（21.2，35）	29.4（23.05，35.55）	1.343	0.179
HbA1c/%	2.44（2.12，2.69）	2.31（2，2.65）	-2.262	0.024
Hb/（g/L）	137（128，147）	139（129，149）	1.3195	0.187
FBG/（mmol/L）	6.55（5.08，7.98）	5.83（4.79，8）	-2.121	0.034
BUN/（nmol/L）	5.3（4.38，6.8）	5.41（4.4，6.5）	-0.268	0.789
UA/（nmol/L）	327（277，390）	324（268，392）	-0.624	0.533
TG/（mmol/L）	1.58（1.15，2.4）	1.62（1.15，2.37）	-0.004	0.997
TC/（mmol/L）	3.9（3.32，4.7）	3.89（3.2，4.68）	-0.305	0.761
HDL-C/（mmol/L）	0.95（0.81，1.14）	0.95（0.8，1.15）	-0.103	0.918
LDL-C/（mmol/L）	2.42（1.91，3.02）	2.40（1.81，3.01）	-0.544	0.587
身高/cm	167（162，170）	172（168，175）	3.598	0.067
体质量/kg	91.80（80.70，105.82）	71.70（58.63，83.75）	-10.537	< 0.001
腰围/cm	97（87，112）	78（64，90）	-10.429	< 0.001
BMI指数	30.72（25.39，35.80）	28.86（24.67，34.52）	-4.431	0.066
LAP指数	56.16（33.48，80.94）	24.84（10.61，44.61）	-8.616	< 0.001
CMI指数	1.10（0.72，1.61）	0.75（0.47，1.26）	-4.912	< 0.001
VAI指数	2.07（1.36，3.87）	2.13（1.37，3.34）	-0.350	0.727
BRI指数	6.03（4.33，8.27）	2.52（1.31，3.93）	-13.155	< 0.001
ABSI指数	0.069（0.067，0.073）	0.071（0.067，0.073）	-1.825	0.068
Gensini评分	72（39，106）	18（7，38）	-10.835	< 0.001

Tab.1

Tab.2

Fig.1

Fig.2

Tab.3

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变量	单因素		多因素
变量	HR（95%CI）	P值	HR（95%CI）	P值
年龄	1.014（0.997 ~ 1.032）	0.110
男性	0.739（0.509 ~ 1.074）	0.113
高血压	2.058（1.396 ~ 3.036）	< 0.001	1.438（0.942 ~ 2.196）	0.093
糖尿病	1.829（1.287 ~ 2.601）	0.001	1.503（1.043 ~ 2.167）	0.029
腹型肥胖	1.617（1.177 ~ 2.373）	0.004	1.670（1.122 ~ 2.503）	0.012
HbA1c	1.154（0.966 ~ 1.378）	0.115
FBG	1.011（0.969 ~ 1.054）	0.621
体质量	1.103（0.217 ~ 1.106）	0.383
腰围	1.051（1.040 ~ 1.154）	0.016	1.081（0.996 ~ 1.173）	0.062
LAP指数	1.011（1.008 ~ 1.014）	< 0.001	0.995（0.988 ~ 1.003）	0.210
CMI指数	1.435（1.235 ~ 1.669）	< 0.001	1.430（1.049 ~ 1.952）	0.024
VAI指数	1.038（0.970 ~ 1.113）	0.282
BRI指数	1.450（1.379 ~ 1.523）	< 0.001	1.332（1.234 ~ 1.439）	< 0.001
ABSI指数	1.067（0.668 ~ 1.833）	0.881
Gensini评分	1.022（1.019 ~ 1.025）	< 0.001	1.015（1.011 ~ 1.019）	< 0.001

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Correlation of novel anthropometric indicators with long⁃term prognosis in patients with acute myocardial infarction

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项目	LAP	CMI	VAI	BRI	ABSI
r值	0.233	0.126	0.037	0.272	0.257
P值	< 0.001	< 0.001	0.328	< 0.001	0.494