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科学研究

Management of Asymptomatic Severe Aortic Stenosis: Evolving Concepts in Timing of Valve Replacement The contribution of tissue-grouped BMI-associated gene sets to cardiometabolic-disease risk: a Mendelian randomization study Transcatheter Versus Surgical Aortic Valve Replacement in Low-Risk Patients Comprehensive comparative effectiveness and safety of first-line antihypertensive drug classes: a systematic, multinational, large-scale analysis Stroke Rates Following Surgical Versus Percutaneous Coronary Revascularization Association of Effective Regurgitation Orifice Area to Left Ventricular End-Diastolic Volume Ratio With Transcatheter Mitral Valve Repair OutcomesA Secondary Analysis of the COAPT Trial Extended antiplatelet therapy with clopidogrel alone versus clopidogrel plus aspirin after completion of 9- to 12-month dual antiplatelet therapy for acute coronary syndrome patients with both high bleeding and ischemic risk. Rationale and design of the OPT-BIRISK double-blinded, placebo-controlled randomized trial Association of Coronary Artery Calcium With Long-term, Cause-Specific Mortality Among Young Adults Transcatheter Aortic Valve Replacement in Low-Risk Patients With Symptomatic Severe Bicuspid Aortic Valve Stenosis Expansion or contraction of stenting in coronary artery disease?

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Original Research2021 Mar 9.

JOURNAL：Diabetes Obes Metab. Article Link

Red Cell Distribution Width in Patients with Diabetes and Myocardial Infarction: an analysis from the EXAMINE trial

JP Ferreira, Z Lamiral, G Bakris et al. Keywords: alogliptin; outcomes; red cell distribution width; T2DM

ABSTRACT

BACKGROUND - Red blood cell distribution width (RDW) is a measure of size variability in the red blood cell population (anisocytosis). Increased RDW may arise from any condition that affects erythropoiesis or the survival of erythrocytes. RDW has been associated with poor prognosis in patients with type 2 diabetes (T2D). Whether RDW is a risk marker for adverse cardiovascular outcomes or also a marker of non‐cardiovascular health concerns is of clinical importance.

AIMS - To determine the clinical correlates of increased RDW, its potential mechanistic association with multiple circulating biomarkers, and its prognostic value, in patients with (T2D) who had a recent acute coronary syndrome.

METHODS - We used time‐updated Cox models applied to patients enrolled in the EXAMINE (Examination of Cardiovascular Outcomes with Alogliptin versus Standard of Care) trial.

RESULTS - A total of 5380 patients were included, the median age was 61 years and 32% were women. Patients with higher RDW were older, more frequently women, with longer duration of diabetes duration, and increased comorbidities. An RDW >16.1% (both baseline and time‐updated) was independently associated with the study primary composite outcome of nonfatal myocardial infarction, nonfatal stroke or cardiovascular death (time‐updated adjusted HR =1.36, 95%CI =1.16–1.61, p < 0.001), all‐cause death (time‐updated adjusted HR =2.01, 95%CI =1.60–2.53, p < 0.001), as well as mortality from non‐CV causes (time‐updated adjusted HR =2.67, 95%CI =1.72–4.15, p < 0.001). RDW had a weak‐to‐moderate correlation with hemoglobin and circulating markers that reflected inflammation, apoptosis, fibrosis and congestion. Alogliptin did not alter RDW values.

CONCLUSIONS - RDW is a marker of disease severity associated with a multitude of poor outcomes, including both cardiovascular and non‐cardiovascular death. RDW correlated modestly with inflammatory, pro‐apoptotic, pro‐fibrotic, and congestion markers, and its levels were not affected by alogliptin during the course of the trial.

科研文章

荐读文献

Red Cell Distribution Width in Patients with Diabetes and Myocardial Infarction: an analysis from the EXAMINE trial

ABSTRACT