摘要
目的探讨血脂变异性与冠心病患者中期不良心血管事件之间的关系。方法回顾性收集了2013年1月1日至2016年12月1日于中日友好医院至少接受过3次(非基线)血脂检测的355例冠心病患者的临床基本资料、合并症、血脂结果及随访情况。血脂检测包括总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和三酰甘油(TG)。血脂变异性采用标准差(SD)、变异系数(CV)和校正独立于均值的变异性(cVIM)进行评估。随访截至2018年5月31日,根据是否发生主要不良心血管事件(MACE)将患者分为MACE组和非MACE组。运用Cox比例风险回归分析,探讨血脂变异性与MACE的相关性。结果平均随访(34.1±12.8)个月后,116例(32.7%)患者发生MACE。与非MACE组相比,MACE组TC变异性(SD:43.1比36.2;CV:0.39比0.29;cVIM:0.34比0.27;均为P<0.001)和HDL-C变异性(SD:5.20比4.64;CV:0.14比0.12;cVIM:0.020比0.017;均为P<0.01)水平更高。在校正平均血脂水平和心血管危险因素后,TC变异性(HR=1.012,95%CI:1.003~1.021,P=0.007)和HDL-C变异性(HR=1.081,95%CI:1.019~1.146,P=0.009)仍能预测更高的MACE发生风险。结论冠心病患者的TC和HDL-C变异性与中期MACE有关,而LDL-C和TG变异性与中期MACE无关。
Objective To investigate the relationship between lipid variability and med-term adverse cardiovascular events in patients with coronary artery disease(CAD).Methods We collected clinical basic data,comorbidities,lipid profile measurement results and follow-up results of 355 CAD patients who had undergone blood lipid measurements at least 3 times postbaseline in the China-Japan Friendship Hospital from January 1,2013 to December 1,2016.Blood lipid levels were tested,including total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)and triglyceride(TG).Lipid variability was assessed using standard deviation(SD),coefficient of variation(CV)and corrected variability independent of the mean(cVIM).Follow-up was up to May 31,2018.According to whether major adverse cardiovascular events(MACE)occurred,patients were divided into MACE group and non-MACE group.Cox proportional hazards regression analysis was used to explore the correlation between lipid variability and MACE.Results After an average follow-up of(34.1±12.8)months,116(32.7%)patients experienced MACE.The MACE group had a higher variability in TC(SD:43.1 vs.36.2;CV:0.39 vs.0.29;cVIM:0.34 vs.0.27;all P<0.001)and HDL-C(SD:5.20 vs.4.64;CV:0.14 vs.0.12;cVIM:0.020 vs.0.017;all P<0.01)compared with the non-MACE group.After adjusting for mean lipid levels and cardiovascular risk factors,lipid variability by SD was still associated with the increased risk of MACE for TC(HR=1.012,95%CI:1.003-1.021,P=0.007)and HDL-C(HR=1.081,95%CI:1.019-1.146,P=0.009).Conclusions High variability of TC and HDL-C are associated with med-term MACE in patients with CAD,whereas LDL-C and TG variability are not associated with MACE.
作者
彭菊琴
廖江铨
王瑞茵
任钧国
高铸烨
李春岩
Peng Juqin;Liao Jiangquan;Wang Ruiyin;Ren Junguo;Gao Zhuye;Li Chunyan(Institute of Basic Medical Sciences,China Academy of Chinese Medical Sciences Xiyuan Hospital,Beijing 100091,China;Department of Cardiology,China Academy of Chinese Medical Sciences Xiyuan Hospital,Beijing 100091,China;Department of Cardiology,China-Japan Friendship Hospital,Beijing 100029,China;Beijing University of Chinese Medicine,Beijing 100029,China)
出处
《中国心血管杂志》
2022年第3期252-257,共6页
Chinese Journal of Cardiovascular Medicine
基金
首都卫生发展科研专项项目重点攻关(2018-1-4171)。
关键词
血脂变异性
冠心病
相关性
主要不良心血管事件
Lipid variability
Coronary disease
Correlation
Major adverse cardiovascular events
