脂蛋白a对行冠状动脉旋磨术患者全因死亡率的影响  

Impact of lipoprotein(a) on long-term all-cause mortality in patients undergoing coronary rotational atherectomy

作　　者：胡宾[1] 贾硕[1] 杨士伟[1] 贾德安[1] 翟光耀[1] 刘宇扬[1] 史冬梅[1] 周玉杰[1] HU Bin;JIA Shuo;YANG Shiwei;JIA Dean;ZHAI Guangyao;LIU Yuyang;SHI Dongmei;ZHOU Yujie(Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart Lung and Blood Vessel Diseases,Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Heart Disease,Clinical Center for Coronary Heart Disease,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所,冠心病精准治疗北京市重点实验室,首都医科大学冠心病临床诊疗与研究中心心内科,100029

出　　处：《心肺血管病杂志》2022年第6期602-605,共4页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国家重点研发计划(2017YFC0908800);北京市医院管理局“登峰”人才培养计划(DFL20150601)。

摘　　要：目的:越清高水平脂蛋白a[Lp(a)]与心血管疾病的不良预后密切相关,故本研究评估Lp(a)对行冠状动脉旋磨术患者全因死亡率的影响。方法:分析自2015年1月至2018年5月,在首都医科大学附属北京安贞医院心内科成功行冠状动脉旋磨术的309例冠心病患者,根据Lp(a)水平,将患者分为高Lp(a)组[n=55,Lp(a)>50g/L]和低Lp(a)组[n=254,Lp(a)≤50g/L],采用Kaplan-Meier生存曲线和Cox比例危险模型分析两组患者的全因死亡率。结果:高Lp(a)组血脂异常明显高于低Lp(a)组(P<0.001)。平均随访(30.77±6.70)个月,Kaplan-Meier生存曲线显示,高Lp(a)组患者的全因死亡率明显高于低Lp(a)组(P=0.016),有统计学意义。调整混杂因素后,高Lp(a)出现全因死亡的(HR=2.107,95%CI:1.074~4.131,P=0.030)。结论:高Lp(a)明显增加行冠状动脉旋磨术冠心病患者的的全因死亡率。Objective: High levels of lipoprotein(a) [Lp(a)] are associated with poor prognosis of the cardiovascular disease.The aim of the study is to assess the impact Lp(a) on the long-term allcause mortality in patients undergoing coronary rotational atherectomy. Methods: The study enrolled 309patients successfully undergoing coronary rotational atherectomy in the Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University between January 2015 and May 2018. Two patient groups were established: a low group with plasma Lp(a) lower than 50 g/L(n =55) and a high group with values above 50 g/L(n=254). Kaplan-Meier estimation and Cox proportional hazards model were used for unadjusted and adjusted analyses for all-cause mortality. Results: The incidence of dyslipidemia in the highLp(a) group were significantly higher than those in the low-Lp(a) group(P<0.001). After following up for a median of(30.77±6.70) months, Kaplan-Meier analysis indicated the cumulative survival rate censored for all-cause mortality were significantly lower in patients in the high group compared with patients in the high group(log-rank test, P=0.016).After adjustment for confounding factors, the hazard ratio(HR) for all-cause mortality was(HR=2.107,95%CI:1.074-4.131,P=0.030). Conclusions: High Lp(a) was significantly associated with a higher risk of long term all-cause mortality in patients undergoing coronary rotational atherectomy.

关 键 词：脂蛋白 冠状动脉旋磨术 死亡率 

分 类 号：R54[医药卫生—心血管疾病]