血浆致动脉粥样硬化指数与急性非ST段抬高型心肌梗死患者介入术后长期预后间的关系  

Relationship between plasma atherogenic index and long-term prognosis after percutaneous coronary intervention in patients with acute non-ST-segment elevation myocardial infarction

作　　者：蔡依梦 钱钢 CAI Yimeng;QIAN Gang(Graduate School of Bengbu Medical College,Bengfu 233030,China)

机构地区：[1]蚌埠医学院研究生院,233030 [2]嘉兴市第一医院心血管内科

出　　处：《心肺血管病杂志》2022年第10期1042-1048,共7页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:观研究表明小而密低密度脂蛋白胆固醇(sdLDL-C)可能比LDL-C更具有显著的致动脉粥样硬化作用。近来发现致动脉粥样硬化指数(AIP)指数可作为sdLDL-C的替代标记物,已被视为血浆致动脉粥样硬化的敏感标志物。既往的研究发现AIP是冠心病和动脉僵硬度的一个新的独立预后生物标志物。但是目前尚未有研究评估AIP与急性非ST段抬高型心肌梗死(NSTEMI)患者预后之间的相关性,所以本研究旨在研究AIP与NSTEMI患者预后之间的相关性。方法:连续筛选了2019年1月至2019年12月,在嘉兴市第一医院,接受经皮冠状动脉介入治疗(PCI)的18~80岁NSTEMI患者,收集入选患者的人口统计学数据和临床特征,主要终点事件是包括全因死亡、非致命性心肌梗死、非致命性卒中或症状驱动的再次血运重建的复合终点。使用Cox比例风险回归模型评价AIP与不良心血管事件的关系。结果:共有1749例患者接受(17.1±3.15)个月随访,并纳入最终分析。入选患者中80.2%为男性,平均年龄为(58±11.3)岁,平均BMI为(26.2±3.36)kg/m^(2)。随访期间共发生121个(6.9%)主要终点事件。将AIP指数进行三分位转换后进行COX回归分析发现,较高的AIP指数水平与不良心血管事件的发生风险密切相关(T2 vs.T1:HR=0.98,95%CI:0.57~1.67,P=0.929;T3 vs.T1:HR=1.60,95%CI:1.10~2.62,P=0.042;P for trend<0.036)。结论:AIP是NSTEMI患者PCI术后发生不良心血管事件的独立危险因素。本研究结果为NSTEMI患者评估预后提供新的指标,早期筛选出风险高危患者,为临床医师改善NSTEMI患者预后并及早进行干预提供依据。Objective:It had shown that sdLDL-C may have more significant atherogenic effect than LDL-C.Recently,it has been found that AIP index can be used as an alternative marker of sdLDL-C and has been regarded as a sensitive marker of plasma atherosclerosis.Previous studies have found that AIP is a new independent prognostic biomarker of coronary heart disease and arterial stiffness.However,there is no study to evaluate the correlation between AIP and the prognosis of acute non ST segment elevation myocardial infarction(NSTEMI)patients.Therefore this study aims to find the correlation between AIP and the prognosis of NSTEMI patients.Methods:patiens aged 18-80 year-old patients with acute non ST segment elevation myocardial infarction who underwent percutaneous coronary intervention(PCI)in our hospital from January 2019 to December 2019 were continuously screened.The demographic data and clinical characteristics of patients were collected.The primary endpoint was the composite end point of all-cause death,non-fatal myocardial infarction,non-fatal stroke or symptom driven revascularization.Cox proportional hazards regression model was used to evaluate the relationship between AIP and adverse cardiovascular events.Results:A total of 1749 patients were followed up for(17.1±3.15)months and included in the final analysis.80.2%of the patients were male,with an average age of(58±11.3)years and an average BMI of(26.2±3.36)kg/m2.A total of 121(6.9%)primary end points occurred during follow-up.Cox regression analysis found that higher AIP index level was closely related to the risk of adverse cardiovascular events(T2 vs.T1:HR=0.98,95%CI:0.57-1.67,P=0.929;T3 vs.T1:HR=1.60,95%CI:1.10-2.62,P=0.042;P for trend<0.036).Conclusions:AIP is an independent risk factor for adverse cardiovascular events after PCI in NSTEMI patients.The results provide a new index for evaluating the prognosis of NSTEMI patients,early screening of high-risk patients,and provide a tool for clinicians to improve the prognosis of NSTEMI patients.

关 键 词：血浆致动脉粥样硬化指数 急性非ST段抬高型心肌梗死 预后 

分 类 号：R54[医药卫生—心血管疾病]