[The relationship between fasting blood glucose level and thromboembolism events in patients with non-valvular atrial fibrillation].
[The relationship between fasting blood glucose level and thromboembolism events in patients with non-valvular atrial fibrillation].
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DOI：
10.3760/cma.j.cn112148-20210419-00351
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发表时间：
2022-03-24
期刊：
影响因子：
--
通讯作者：
Ma, C S
中科院分区：
文献类型：
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作者：
Bo, X W;Zuo, S;Ma, C S
目的：探讨非瓣膜性心房颤动（NVAF）患者空腹血糖水平与血栓栓塞事件的关系。研究方法：这是一项基于多中心、前瞻性中国房颤登记研究队列数据的观察性研究，该队列纳入了2011年8月至2018年12月北京31家医院的18703例连续房颤（AF）患者。根据入院时合并糖尿病的情况和空腹血糖水平将患者分为5组：血糖正常组（血糖正常组）、糖尿病前期组、严格血糖控制组、血糖控制一般组和血糖控制不佳组。每6个月通过电话或门诊随访患者。主要随访终点是血栓栓塞事件，包括缺血性卒中和全身性栓塞。次要终点是心血管死亡和血栓栓塞事件的复合终点。采用Kaplan-Meier生存分析和多因素考克斯回归分析空腹血糖水平与终点事件的相关性。结果：18703例NVAF患者年龄（63.8±12.0）岁，男性11503例（61.5%）。血糖正常组11877例（63.5%），糖尿病前期组2023例（10.8%），严格血糖控制组1131例（6.0%），血糖控制一般组811例（4.3%），血糖控制不良组2861例（4.3%）。4803例糖尿病患者中，1131例（23.5%）血糖得到严格控制，其中328例（29.0%）为低血糖（空腹血糖水平
Objective: To explore the relationship between fasting blood glucose level and thromboembolism events in patients with non-valvular atrial fibrillation (NVAF). Methods: This was an observational study based on data from a multicenter, prospective Chinese atrial fibrillation registry cohort, which included 18 703 consecutive patients with atrial fibrillation (AF) in 31 hospitals in Beijing from August 2011 to December 2018. Patients were divided into 5 groups according to status of comorbid diabetes and fasting glucose levels at admission: normal blood glucose (normal glucose group), pre-diabetes group, strict glycemic control group, average glycemic control group and poor glycemic control group. Patients were followed up by telephone or outpatient service every 6 months. The primary follow-up endpoint was thromboembolic events, including ischemic stroke and systemic embolism. The secondary endpoint was the composite endpoint of cardiovascular death and thromboembolic events. Kaplan-Meier survival analysis and multifactorial Cox regression were used to analyze the correlation between fasting glucose levels and endpoint events. Results: The age of 18 703 patients with NVAF was (63.8±12.0) years, and there were 11 503 (61.5%) male patients. There were 11 877 patients (63.5%) in normal blood glucose group, 2 023 patients (10.8%)in pre-diabetes group, 1 131 patients (6.0%) in strict glycemic control group, 811 patients in average glycemic control group and 2 861 patients(4.3%) in poor glycemic control group. Of the 4 803 diabetic patients, 1 131 patients (23.5%) achieved strict glycemic control, of whom 328 (29.0%) were hypoglycemic (fasting blood glucose level