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目的:了解体质量指数(BMI)对非ST段抬高急性冠状动脉综合征患者血运重建治疗后的预后影响。方法:以DESIRE Ⅱ(The second drug-eluting stent impact on revascularization registry Ⅱ)为单中心回顾性注册研究,入选2003年7月1日至2005年9月30日在我院接受血运重建治疗的6 005例患者,2006年9月1日至11月30日对患者进行电话或门诊随访。本研究入选其中有体质量指数资料的非ST段抬高急性冠状动脉综合征病例3 001例。将这些患者按BMI分为2组,体质量指数(BMI)<23组和BMI≥23组,比较2组之间的临床情况和预后情况。不良心脑血管事件(MACCE)包括全因死亡、非致死性心肌梗死、非致死性卒中和再次血运重建。结果:共3 001例患者,BMI<23组506例和BMI≥23组2 495例,与BMI<23组的患者相比,BMI≥23组的患者年龄较小,伴随危险因素(高血压、糖尿病和高脂血症)较多,完全血运重建率低,总病死率低[HR 0.461,95%CI 0.262～0.808],2组心血管病死率和总MACCE发生率差异无统计学意义。结论:在非ST段抬高急性冠状动脉综合征患者中,尽管BMI≥23组相对BMI<23者有更多的危险因素,但是接受血运重构治疗后的总病死率低。
Objective: To understand the impact of body mass index (BMI) on the prognosis of patients with non-ST segment elevation acute coronary syndrome after revascularization. METHODS: A retrospective registry study with DESIRE Ⅱ (The second drug-eluting stent impact on revascularization registry Ⅱ) was enrolled in our hospital from July 1, 2003 to September 30, 2005 for revascularization 005 patients, September 1, 2006 to November 30 patients by telephone or out-patient follow-up. This study included 3 001 cases of non-ST segment elevation acute coronary syndromes with body mass index data. According to BMI, these patients were divided into two groups according to their body mass index (BMI) <23 and BMI≥23. The clinical status and prognosis were compared between the two groups. Cardiac adverse cardiovascular events (MACCE) include all-cause, non-fatal myocardial infarction, non-fatal stroke and revascularization. Results: Of the 3 001 patients, 506 were in the BMI <23 group and 2 495 were in the BMI ≥ 23 group. Compared with those in the BMI group <23, the patients with BMI ≥ 23 were younger and were associated with risk factors (hypertension, Diabetes and hyperlipidemia), low complete revascularization and low total mortality [HR 0.461, 95% CI 0.262-0.808]. There was no significant difference in the incidence of cardiovascular mortality and total MACCE between the two groups. CONCLUSION: In patients with non-ST-segment elevation acute coronary syndrome, the overall mortality after revascularization is low, although there are more risk factors for BMI 23 than for BMI <23.