Patients phenotypes and cardiovascular risk in type 2 diabetes: the Jackson Heart Study.
Patients phenotypes and cardiovascular risk in type 2 diabetes: the Jackson Heart Study.
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DOI：
10.1186/s12933-022-01501-z
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发表时间：
2022-06-01
影响因子：
9.3
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中科院分区：
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--
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与2型糖尿病相关的心血管预后可能无法通过肥胖和高血压等并存疾病的信息充分捕获。为了了解糖尿病患者的心血管预后，我们使用基于临床数据、超声心动图指标和生物标志物的聚类方法进行表型分型。我们对杰克逊心脏研究中529例黑人糖尿病患者的临床、生化和超声心动图变量进行了聚类分析。使用考克斯比例风险模型评估了确定的聚类与主要不良心血管事件（MACE-冠心病、卒中、心力衰竭和房颤的复合事件）之间的相关性。聚类分析将糖尿病患者（68%为女性，平均年龄60 ± 10岁）分为3个不同的聚类（聚类1、2和3-聚类3为肥厚聚类，其特征为最高LV质量、脑钠肽[BNP]和高敏心肌肌钙蛋白-I [hs-cTnI]水平）。在中位数12.1年后，有141例心血管事件。与第1组相比，第3组心血管疾病风险增加（风险比[HR] 1.60; 95%置信区间[CI] 1.08，2.37），而第2组结局风险相似（HR 1.11; 95% CI 0.73，168）。在黑人糖尿病患者中，聚类分析确定了三种不同的超声心动图和生物标志物表型，聚类3（高LV质量，高心脏生物标志物）与不良结局相关，从而突出了亚临床心肌功能障碍的预后价值。在线版本包含补充材料，可通过10.1186/s12933-022-01501-z获得。
Cardiovascular prognosis related to type 2 diabetes may not be adequately captured by information on comorbid conditions such as obesity and hypertension. To inform the cardiovascular prognosis among diabetic individuals, we conducted phenotyping using a clustering approach based on clinical data, echocardiographic indices and biomarkers. We performed a cluster analysis on clinical, biochemical and echocardiographic variables from 529 Blacks with diabetes in the Jackson Heart Study. An association between identified clusters and major adverse cardiovascular events (MACE- composite of coronary heart disease, stroke, heart failure and atrial fibrillation) was assessed using Cox proportional hazards modeling. Cluster analysis separated individuals with diabetes (68% women, mean age 60 ± 10 years) into three distinct clusters (Clusters 1,2 &3 - with Cluster 3 being a hypertrophic cluster characterized by highest LV mass, levels of brain natriuretic peptide [BNP] and high-sensitivity cardiac troponin-I [hs-cTnI]). After a median 12.1 years, there were 141 cardiovascular events. Compared to Cluster1, Clusters 3 had an increased risk of cardiovascular disease (hazard ratio [HR] 1.60; 95% confidence interval [CI] 1.08, 2.37), while Cluster 2 had a similar risk of outcome (HR 1.11; 95% CI 0.73, 168). Among Blacks with diabetes, cluster analysis identified three distinct echocardiographic and biomarkers phenotypes, with cluster 3 (high LV mass, high cardiac biomarkers) associated with worse outcomes, thus highlighting the prognostic value of subclinical myocardial dysfunction. The online version contains supplementary material available at 10.1186/s12933-022-01501-z.
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影响因子：
24
作者：
McEvoy, John W.;Chen, Yuan;Selvin, Elizabeth
通讯作者：
Selvin, Elizabeth
影响因子：
9.3
作者：
Hiruma S;Shigiyama F;Hisatake S;Mizumura S;Shiraga N;Hori M;Ikeda T;Hirose T;Kumashiro N
通讯作者：
Kumashiro N
影响因子：
24
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通讯作者：
Cannon CP
影响因子：
24
作者：
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通讯作者：
Derumeaux, Genevieve
影响因子：
24
作者：
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通讯作者：
Taylor, Herman A.