期刊
CIRCULATION JOURNAL
卷 80, 期 3, 页码 677-+出版社
JAPANESE CIRCULATION SOC
DOI: 10.1253/circj.CJ-15-0942
关键词
Chronic heart failure; Metabolic syndrome; Obesity; Prognosis; Sex differences
资金
- Japanese Ministry of Health, Labor, and Welfare, Tokyo, Japan [08005713, 18190401, 21170901, 24120301]
- Grants-in-Aid for Scientific Research [25330032] Funding Source: KAKEN
Background: Metabolic syndrome (MetS) is involved in the increased risk of atherosclerotic cardiovascular diseases. We have previously reported that the prevalence of MetS is more than 2-fold greater in patients with chronic heart failure (CHF) than in the general population in Japan. However, the prognostic impact of MetS in CHF patients remains to be elucidated. Methods and Results: In the present nationwide, large-scale clinical study in Japan, we enrolled 4,762 patients with Stage C/D CHF. The prevalence of MetS by the definition of the Japanese Committee for the Diagnostic Criteria in 2005 was 41.3% (50.6% in males, 21.5% in females). MetS was characterized by higher prevalence of males, obesity and lifestyle-related comorbidities, including glucose intolerance, dyslipidemia and hypertension. Multivariate Cox hazard analysis showed that MetS was associated with increased incidence of the composite of all-cause death and atherosclerotic events in males (hazard ratio [HR] 1.28; 95% confidence interval [CI] 1.06-1.54, P=0.011) but not in females (HR 1.23, 95% CI 0.87-1.75, P=0.241). Among the components of MetS, over waist circumference and glucose intolerance were significantly associated with increased incidence of the composite endpoint (HR 1.23, P=0.038, and HR 1.29, P<0.001, respectively) in males but not in females. Conclusions: The results indicate that MetS only has a negative prognostic impact in male CHF patients.
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