Study On The Relationship Between The Severity And Prognosis Of Coronary Artery Lesions And Fasting Plasma Glucose And Metabolic Syndrome

In this study,a total of 913 consecutive patients underwent coronary angiography were selected according to inclusion criteria,to evaluate the correlation between fasting plasma glucose and the affection extent and severity of coronary artery.And to evaluate the rationality of lowering the cutoff value of impaired fasting glucose(IFG),these 913 patients were studied in view of the affection extent and severity of angiographic coronary artery and the cardiovascular risk factors with different FPG levels.Moreover there were 269 senile CAD patients underwent PCI were selected at baseline and were followed up for 5 years,they were observed the prognosis after PCI and the correlated risk factors,and we analyzed the relationship of FPG with angiographic restenosis and major adverse cardiac event to provided some evidences to establish the criteria of IFG.Then a total of 256 CAD patients were selected who were followed up for 5 years,to observe the prognosis after PCI and to analyze the relationship of MS with angiographic restenosis and major adverse cardiac event.In this study logistic regression analysis indicated that the FPG had significant correlation with whether or not CAD was diagnosed by angiography. Adjusting with age,sex and other influencing factors,the FPG still had significant correlation with the number of diseased vessels and the CAD Gensini cumulative index(p＜0.05 or＜0.01,respectively).Univariate analysis revealed that the number of diseased vessels increased with increasing FPG even in prediabetic period.Compared with group of FPG＜5.6 mmol/L,the number of diseased vessels in group of FPG 5.6-6.0 mmol/L were increasing significantly(p＜0.05),after adju-stment of age,sex and other influencing factors;the group of FPG 6.1- 6.9mmol/L had elevation both in the number of diseased vessels and the CAD Gensini cumulative index(p＜0.01).The frequencies of overweight,hypertension, dyslipidemia,metabolic syndrome were increasing with graded FPG levels.FPG at 5.0-5.5mmol/L level dyslipidemia frequency elevated significantly(p＜0.05), and FPG at 5.6-6.0mmol/L level the metabolic syndrome and other components elevated significantly(p＜0.05).After 5 years follow-up,the occurrence rates of major adverse cardiac events, one more revascularization,recurring heartstroke and angiographic restenosis of group 2(5.6mmol/L≤FPG＜6.1mmol/L)were significantly higher than those of group 1(FPG＜5.6mmol/L)(p＜0.05),however there was no significant difference between group 3 and group 2.Compared with group 1,the cumulative survival rates after 5 years follow-up of group2,group 3 and group 4 were significantly decreased(p＜0.05,respectively),there was no remarkably difference between group 2 and group 3.The Logistic regression model analysis showed that FPG was the correlated risk factor of the angiographic restenosis, incidence of major adverse cardiac events,all-cause mortality and recurring heartstroke(P＜0.05,respectively).After 5 years follow-up,compared with non-MACE patients,MACE patients had more components of MS(p＜0.05 or＜0.01,respectively);With the clustering of the MS components,the risk of MACE raised.After 5 years follow-up,Compared with non-MS patients,MS patients had higher occurrence rates of major adverse cardiac events(48.45%vs 23.90%),nonlethal-MI(12.37% vs 4.40%),re-intervention(37.11%vs 18.24%),recurring heartstroke(55.67%vs 35.85%)and angiographic restenosis(45.36%vs 18.24%)(p＜0.05 or＜0.01, respectively),the cumulative survival rates from cardiovascular events was significantly decreased(p=0.0001);Logistic regression analysis indicated that MS was an independent predicator of major adverse cardiac events(p＜0.05).In conclusion,The extent and severity of angiographic coronary artery disease had significant correlation with the fasting plasma glucose,and the extent and severity increased with increasing FPG even in prediabetic period.The extent and severity of angiographic coronary artery disease increased with increasing FPG even in prediabetic period.The risk of angiographic coronary artery disease become elevated significantly from FPG at 5.6-6.1mmol/L level.The CVD risk also increased with increasing FPG even in prediabetic period.The phenomenon of clustering of CVD risk factors was found at FPG 5.6 mmol/L.The incidence rates of major adverse cardiac events,target lesion revascularization,recurring heartstroke and angiographic restenosis,whose FPG between 5.6mmol/L to 6.0mmol/L,are increased significantly compared with the population whose FPG are lower than 5.6mmol/L,however has no difference with the population whose FPG between 6.1mmol/L to 7.0mmol/L.Decreasing the lower limit of IFG to 5.6mml/L will make an great effect in improving the prognosis after PCI of the senile population with CAD.In the senile CAD population,the components of MS were closely relative with the incidence of MACE;With the clustering of the components,the risk of MACE raised gradually.The MS people,had higher incidence rates of major adverse cardiac events and angiographic restenosis,and the cumulative survival rate from cardiovascular events was significantly decreased.MS were independently associated with worse late prognosis of PCI.