Neck-to-Waist Ratio Identifies Chronic Hypertensive Phenotype and Occlusive Myocardial Infarction in Patients Presenting With Acute Coronary Syndrome
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 238
- 试验地点
- 1
- 主要终点
- Association Between Anthropometric Phenotype and Elevated Admission Blood Pressure in Acute Coronary Syndrome
研究概览
简要总结
aim of this study was to evaluate the relationship between multiple conventional and novel anthropometric measurements and hypertension in patients presenting to the ED with ACS and whether anthropometric indices differ according to admission BP status and evaluated the relationship between regional adiposity-related anthropometric phenotypes and cardiovascular stress response in ACS presentations. Rather than representing a general population-based study, this study evaluates the association between ACS and elevated admission BP in a population already characterized by a substantial metabolic disease burden.
详细描述
Patients presenting to the ED with chest pain or anginal equivalents who were diagnosed with ACS after evaluation with physical examination, cardiac biomarkers, and imaging studies, and who were subsequently hospitalized for coronary imaging, were included in the study. Patients excluded from the study are presented in the study flowchart (Figure 1).
Vital parameters, including initial admission BP, pulse rate, oxygen saturation (SpO₂), and heart rate, as well as electrocardiographic findings, were recorded. Laboratory parameters obtained at initial admission, including complete blood count, biochemical parameters, blood gas analysis, and cardiac troponin levels, were recorded. Additional laboratory findings obtained after hospitalization, including uric acid, lipid profile, and proBNP levels, were also documented. Echocardiographic measurements performed prior to the procedure were recorded.
Anthropometric measurements were obtained immediately before the procedure or within the first 24 hours after the procedure. NC, WC, HC, and TC measurements were performed and waist-to-hip ratio (WHR), waist-to-thigh ratio (WTR), neck-to-waist ratio (NWR) were calculated accordingly. All anthropometric measurements were obtained in accordance with the standardized procedures outlined in the NHANES Anthropometry Procedures Manual [12]. Body weight was measured in kilograms using a digital weight scale, and height was measured in centimeters using a height scale. Anthropometric measurements were obtained in centimeters using a measurement tape and recorded accordingly.
Findings obtained after coronary angiography, including the affected vessel, number of involved vessels, degree of involvement, and procedures performed (PTCA, stent implantation, thrombus aspiration, CABG, no intervention), were documented.
Length of hospital stay (ward and intensive care unit), recurrent ED admissions, and 30-day mortality were also recorded. In this study, occlusive myocardial infarction (OMI) was defined as the presence of an acute culprit lesion causing complete or near-complete limitation of coronary blood flow (TIMI flow grade 0-2) requiring emergent reperfusion therapy, and patients were classified according to coronary angiographic findings.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients presenting to the emergency department with chest pain or anginal equivalents, diagnosed with ACS, admitted to CICU for coronary angiography
- •aged over 18 years
排除标准
- •Patients with anatomical abnormalities in the regions where anthropometric measurements were to be performed (n=11)
- •Patients with endocrinological disorders causing anatomical abnormalities of the neck, waist, or hip circumference (n=3)
- •Patients with neck tumors (n=1)
- •ACS patients who did not undergo coronary angiography(n=6)
- •Etiologies causing secondary troponin elevation (e.g., pulmonary embolism, aortic dissection, hypoxia-related pathologies, sepsis, and anemia) (n=51)
- •Mean arterial pressure < 65 mmHg (n=9)
- •Patients unable to stand upright (n=18)
- •Patients with ascites (n=1)
研究组 & 干预措施
normal blood pressure at admission group
patients admitted to emergency department with normal blood pressure
elevated blood pressure at admission group
patients admitted to emergency department with elevated blood pressure
结局指标
主要结局
Association Between Anthropometric Phenotype and Elevated Admission Blood Pressure in Acute Coronary Syndrome
时间窗: Anthropometric measurements and blood pressure values were obtained during the index hospitalization, with anthropometric measurements performed immediately before coronary angiography or within the first 24 hours following the procedure.
The primary outcome was the difference in conventional and regional adiposity-related anthropometric measurements between patients with elevated admission blood pressure and those with normal admission blood pressure at emergency department presentation.
次要结局
未报告次要终点