Prognostic value of non high density lipoprotein cholesterol for the occurrence of cardiovascular events in patients with acute coronary syndrome
-
摘要: 目的:探讨非高密度脂蛋白胆固醇(non-HDL-C)对急性冠状动脉综合征(ACS)患者事件的预测价值。方法:对2008-2010年期间324例出院的ACS患者进行随访,通过多元Logistic回归方法分析血清基线non-HDL-C水平对随访期间初级终点事件(全因死亡、非致死性心肌梗死及卒中)及次级终点事件(Ⅳ级心功能衰竭和再血管化治疗)的相关性。结果:①初级终点事件组患者血清non-HDL-C水平高于未发生事件组患者[(3.75±1.12)mmol/L:(3.07±0.69)mmol/L,P<0.05]。②多因素Logistic回归分析发现,血清基线non-HDL-C对初级终点(OR值2.996,95%CI1.269~7.072,P=0.012)和全因死亡(OR值2.983,95%CI 1.189~7.482,P=0.020)的发生有预测价值,但对次级终点事件的发生无预测价值。结论:血清non-HDL-C对ACS患者初级终点事件及全因死亡的发生有预测价值,可以作为监测ACS预后及指导调脂治疗的重要临床指标。
-
关键词:
- 急性冠状动脉综合征 /
- 非高密度脂蛋白胆固醇 /
- 初级终点事件
Abstract: Objective:To investigate the prognostic value of non high density lipoprotein cholesterol(non-HDL-C) for the occurrence of cardiovascular events in patients with acute coronary syndrome(ACS). Method:This study enrolled 324 cases with ACS from 2008 to 2010,and followed up 18 months.Cardiovascular events in this study included primary(all-cause mortality,nonfatal myocardial infarction and nonfatal stroke) and secondary(class Ⅳ heart failure and revascularization treatment) end-point events.The association between baseline non-HDL-C level and the risk of primary and secondary end-point events was analyzed by multivariable logistic regression. Result:①The baseline level of non-HDL-C of patients with primary end-point events was higher(3.75±1.12 mmol/L) than that in patients without the events(3.07±0.69 mmol/L,P<0.05).②Multivariate logistic regression analysis showed that high level of non-HDL-C at baseline was a key predictor of primary end-point events(OR 2.996,95%CI 1.269-7.072,P=0.012) and all-cause mortality(OR 2.983,95%CI 1.189-7.482,P=0.020),but no prognostic value for the occurrence of secondary end point events. Conclusion:Baseline level of non-HDL-C has a prognostic value of primary end-point events and all-cause mortality,and plays an important clinical target for monitoring ACS prognosis and guiding lipid management. -
-
[1] GINSBERG H N.New perspectives on atherogene-sis:role of abnormal triglyceride-rich lipoprotein me-tabolism[J].Circulation,2002,106:2137-2142.
[2] National Cholesterol Education Program(NCEP)Ex-pert Panel on Detection,Evaluation,and Treatmentof High Blood Cholesterol in Adults(Adult Treat-ment PanelⅢ).Third report of the National Choles-terol Education Program(NCEP)expert panel on de-tection,evaluation,and treatment of high blood cho-lesterol in adults(Adult Treatment PanelⅢ)final re-port[J].Circulation,2002,106:3143-3421.
[3] NAKAMURA M,KOYAMA I,ISO H,et al.Meas-urement performance of reagent manufacturers bycenters for disease control and prevention/cholesterolreference method laboratory network lipid standardi-zation specified for metabolic syndrome-focused healthcheckups program in Japan[J].J AtherosclerThromb,2009,16:756-763.
[4] RAY K K,CANNON C P,CAIRNS R,et al.Prog-nostic utility of apoB/AI,total cholesterol/HDL,non-HDL cholesterol,or hs-CRP as predictors ofclinical risk in patients receiving statin therapy afteracute coronary syndromes:results from PROVE IT-TIMI 22[J].Arterioscler Thromb Vasc Biol,2009,29:424-430.
[5] 任洁,赵冬,刘静.非高密度脂蛋白胆固醇水平与中国人群心血管病发病危险的相关性[J].中华心血管病杂志,2010,38(10):934-938.
[6] NODA H,ISO H,IRIE F,et al.Association be-tween non-high-density lipoprotein cholesterol concen-trations and mortality from coronary heart disease a-mong japanese men and women:the ibaraki prefectur-al health study[J].J Atheroscler Thromb,2010,17:30-36.
[7] 李健斋,王抒,曾平.非高密度脂蛋白胆固醇用于评估及预测冠心病危险[J].中华心血管病杂志,2004,32(11):963-966.
[8] RIDKER P M,RIFAI N,COOK N R,et al.Non-HDL cholesterol,apolipoproteins A-I and B100,standard lipid measures,lipid ratios,and crp as riskfactors for cardiovascular disease in women[J].JA-MA,2005,294:326-333.
[9] BITTNER V.Non-high-density lipoprotein cholester-ol and cardiovascular disease[J].Curr Opin Lipidol,2003,14:367-371.
-
计量
- 文章访问数: 44
- PDF下载数: 33
- 施引文献: 0
下载: