Background. One of the key concerns of the clinician is to identify and manage risk factors for major adverse cardiovascular events (MACEs) in nondiabetic and diabetic patients with acute coronary syndrome (ACS) undergoing stent implantation. Mean corpuscular volume (MCV) is a marker of erythrocyte size and activity and is associated with prognosis of cardiovascular disease. However, the role of admission MCV in predicting MACEs following stent implantation in diabetes mellitus (DM), non-DM, or whole patients with ACS remains largely unknown. Methods and Results. A total of 437 ACS patients undergoing stent implantation, including 294 non-DM ( years) and 143 DM ( years), were analyzed. Admission MCV was higher in non-DM than DM patients. During a median of 31.93 months follow-up, Kaplan-Meier curve demonstrated that higher admission MCV level was significantly associated with increased MACEs in whole and non-DM, but not in DM patients. In Cox regression analysis, the highest MCV tertile was associated with higher MACEs in whole ([HR] 1.870, 95% CI 1.113-3.144, ), especially those non-DM ([HR] 2.089, 95% CI 1.077-4.501, ) patients after adjustment of several cardiovascular risk factors. MCV did not predict MACEs in DM patients. During landmark analysis, admission MCV showed better predictive value for MACEs in the first 32 months of follow-up than in the subsequent period. Finally, the receiver operating characteristic (ROC) curve was conducted to confirmed the value of admission MCV within 32 months. Conclusion. In patients with ACS, elevated admission MCV is an important and independent predictor for MACEs following stent implantation, especially amongst those without DM even after adjusting for lifestyle and clinical risk factors. However, as the follow-up period increased, the admission MCV lost its ability to predict MACEs.

中文翻译：

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入院平均红细胞体积对非糖尿病和糖尿病合并急性冠脉综合征患者支架植入后主要心血管不良事件的预后价值。

背景。临床医生的主要关注点之一是识别和管理接受支架植入的非糖尿病和急性冠状动脉综合征 (ACS) 患者的主要不良心血管事件 (MACE) 的危险因素。平均红细胞体积 (MCV) 是红细胞大小和活性的标志，与心血管疾病的预后相关。然而，入院 MCV 在预测糖尿病（DM）、非 DM 或整个 ACS 患者支架植入后 MACE 中的作用仍然很大程度上未知。方法和结果。共有 437 名 ACS 患者接受支架植入，其中 294 名非 DM（年）和 143 DM（年），进行了分析。非 DM 患者的入院 MCV 高于 DM 患者。在中位 31.93 个月的随访期间，Kaplan-Meier 曲线表明，较高的入院 MCV 水平与整体和非 DM 患者的 MACE 增加显着相关，但与 DM 患者无关。在 Cox 回归分析中，最高 MCV 三分位数与总体上更高的 MACE 相关（[HR] 1.870, 95% CI 1.113-3.144,)，尤其是那些非 DM ([HR] 2.089, 95% CI 1.077-4.501,)调整几个心血管危险因素后的患者。MCV 不能预测 DM 患者的 MACE。在里程碑分析期间，入院 MCV 在随访的前 32 个月中显示出比后续阶段更好的 MACE 预测价值。最后，通过受试者工作特征（ROC）曲线确定入院后32个月内MCV的值。结论。在 ACS 患者中，入院 MCV 升高是支架植入后 MACE 的重要且独立的预测因子，尤其是在没有 DM 的患者中，即使在调整生活方式和临床风险因素后也是如此。然而，随着随访时间的增加，入院 MCV 失去了预测 MACE 的能力。