摘要
目的:本研究主要探索残余脂蛋白胆固醇(RLP-C)与急性冠状动脉综合征(ACS)患者术后中远期临床预后的相关性。方法:连续性纳入2016年1月至2018年6月,于我院成功置入药物洗脱支架的ACS患者,对所有的研究人群随访2年。主要心血管不良事件(MACEs)主要包括心源性死亡、靶病变血运重建及心肌梗死。参照既往研究,通过公式:TC减LDL-C减HDL-C计算RLP-C。结果:本研究共纳入738例,随访2年结束,共有65例发生了MACEs。与MACE(-)相比,MACE(+)组RLP-C水平明显升高[0.72(0.46, 1.005) vs. 0.48(0.32,0.74)mmol/L,P<0.001]。ROC曲线分析发现RLP-C可预测ACS患者术后2年MACEs风险(曲线下面积=0.664,95%CI:0.598~0.729,P<0.001),最佳截断值为RLP-C> 0.57mmol/L。进一步分析发现RLP-C>0.57mmol/L组2年MACEs风险显著高于RLP-C≤0.57mmol/L组(14.4%vs. 4.9%, Log Rank <0.001)。最后通过Cox回归分析证实, RLP-C无论作为连续变量还是分类变量均与ACS患者中远期MACEs事件风险独立相关(连续变量:HR=1.669,95%CI:1.057~2.634, P=0.028);分类变量(RLP-C>0.57mmol/L:HR=2.519,95%CI:1.457~4.353,,P=0.001)。结论:RLP-C与ACS患者术后中远期MACEs风险独立相关。未来RLP-C有可能作为进一步改善ACS患者预后的治疗靶目标。
Objective:Recently,increasing evidences suggest that remnant-like particle cholesterol(RLP-C)is closely related to atherosclerosis.The purpose of this study was to explore the correlation between RLP-C and the mid-and long-term prognosis in patients with coronary heart disease after intervention.Methods:This study mainly included patients with acute coronary syndrome(ACS)successfully implanted with drug-eluting stents in our hospital from January 2016 to June 2018.In this study,all the study population were followed up for 2 years,and major cardiovascular adverse events(MACEs)were defined,which includes cardiac death,target lesion revascularization,and myocardial infarction.With reference to previous studies, RLP-C is calculated by the formula of total cholesterol minus low-density lipoprotein cholesterol minus high-density lipoprotein cholesterol. Results: A total of 738 patients were included in this study, and 65 patients had MACEs at the end of the 2 years follow-up. Compared with MACE (-) , the level of RLP-C in MACE (+) group was significantly higher [ 0.72(0.46, 1.005) vs. 0.48(0.32, 0.74)mmol/L, P<0.001]. The receiver operating characteristic curve (ROC) analysis revealed that RLP-C could predict the risk of MACEs in ACS patients at 2 years after intervention (area under the curve=0.664, 95%CI:0.598-0.729, P<0.001), and the optimal cutoff value was RLP-C > 0.57mmol/L. Further analysis showed that the 2-year MACEs risk in the group with RLP-C>0.57mmol/L was significantly higher than that in the group with RLP-C ≤ 0.57 mmol/L(14.4% vs. 4.9%, Log Rank<0.001). Finally, Cox regression analysis confirmed that RLP-C, either as a continuous variable or a categorical variable, was independently related to the risk of mid and long-term MACEs (continuous variable: HR=1.669, 95%CI:1.057-2.634, P=0.028)categorical variable (RLP-C>0.57mmol/L:HR=2.519, 95%CI:1.457-4.353, P=0.001). Conclusions: RLP-C was independently associated with the risk of mid and long-term MACEs in ACS patients. RLP-C may be a therapeutic target
作者
梁茜茜
王宝玉
刘畅
王天宝
LIANG Qianqian;WANG Baoyu;LIU Chang;WANG Tianbao(Department of EICU,Zhengzhou Central Hospital affiliated to Zhengzhou University,Zhengzhou 45000,China)
出处
《心肺血管病杂志》
CAS
2023年第3期209-214,共6页
Journal of Cardiovascular and Pulmonary Diseases
