急性冠脉综合征患者血清钙与心血管预后的关系

目的 探讨急性冠脉综合征(acute coronary syndrome, ACS)患者血清钙与心血管预后的相关性。方法 选取2019年6月至2019年12月首都医科大学附属北京天坛医院心血管内科收治住院的ACS患者721例，所有患者均行冠状动脉造影。收集患者的临床资料，采集血标本测定血清钙等生化指标。所有患者随访1年，记录终点事件的发生情况。分析血清钙与ACS患者心血管预后的关系。结果 721例ACS患者，平均年龄(62.23±10.00)岁，男性527例(73.1%),平均随访(10.92±2.96)个月，110例(15.26%)发生终点事件，其中心血管死亡1例、再次心肌梗死3例、不稳定性心绞痛103例、缺血性卒中3例。所有患者根据血清钙四分位数分为Q₁组(<2.20 mmol/L)、Q₂组(2.20～2.26 mmol/L)、Q₃组(2.27～2.31 mmol/L)、Q₄组(≥2.32 mmol/L)。Q₁组急性心肌梗死患者比例高于Q₃组和Q...

Correlation between serum calcium and cardiovascular outcome in patients with acute coronary syndrome

Objective To investigate the relationship between serum calcium and cardiovascular prognosis in patients with acute coronary syndrome (ACS). Method A total of 721 ACS patients hospitalized in the Department of Cardiovascular Medicine, Beijing Tiantan Hospital,Capital Medical University from June 2019 to December 2019 were selected, and all patients underwent coronary angiography. The clinical data of the patients were collected and blood samples were drawn to determine biochemical indexes such as serum calcium. All patients were followed up for 1 year. And the occurrence of endpoint events was recorded. The relationship between serum calcium and cardiovascular prognosis in ACS patients was analyzed. Results Among the 721 ACS patients, the mean age was (62.23±10.00) years, 527 (73.1%) were males, and the mean follow-up was (10.92±2.96) months. Among them, 110 patients (15.26%) had an end point event, including 1 case of cardiovascular death, 3 cases of recurrent myocardial infarction, 103 cases of unstable angina, and 3 cases of ischemic stroke. All patients were divided into group Q₁ (<2.20 mmol/L), group Q₂ (2.20－2.26 mmol/L), group Q₃ (2.27－2.31 mmol/L) and group Q₄ (≥2.32 mmol/L).The proportion of patients with acute myocardial infarction in Q1 group was higher than that in Q₃ and Q₄ groups (P <0.05), the GRACE score in Q₁ group was higher than that in Q₂, Q₃ and Q₄ groups (P<0.05), and the incidence of cardiovascular events in Q₁ group was higher than that in Q₄ group (P<0.05). Kaplan-meier analysis showed that patients with the lowest serum calcium level had a worse cardiovascular prognosis (log-rank χ²=9.787, P=0.020). In addition, after adjusting for potential confounders in the multivariate Cox proportional risk model, lower serum calcium level (HR=0.096, 95%CI:0.014－0.646, P=0.016) was independently associated with cardiovascular outcomes. Conclusion Low serum calcium level is an independent risk factor for adverse cardiovascular outcome in patients with ACS. And the decrease of serum calcium level has an important reference value for identifying high-risk ACS patients.