血浆致动脉粥样硬化指数对急性心肌梗死发生的预测价值  

Predictive value of atherogenic index of plasma for acute myocardial infarction

作　　者：吕素洁 吴寿岭[1] 朱辰蕊[1] 李金锋[1] 黄喆[1] 王艳丽[1] 季春鹏[1] Lyu Sujie;Wu Shouling;Zhu Chenrui;Li Jinfeng;Huang Zhe;Wang Yanli;Ji Chunpeng(Department of Cardiology,Kailuan General Hospital,Tangshan 063000,China)

机构地区：[1]开滦总医院心内科,唐山063000

出　　处：《中国心血管杂志》2024年第1期40-45,共6页Chinese Journal of Cardiovascular Medicine

摘　　要：目的探讨血浆致动脉粥样硬化指数(AIP)对急性心肌梗死(AMI)发生的影响,并评价其预测价值。方法前瞻性队列研究。选取2006年7月至2007年10月参加健康体检的既往无心肌梗死病史且基线资料完整的98875名开滦集团公司职工作为观察队列,随访至2019年12月31日,以新发AMI作为终点事件。根据AIP将研究人群进行四分位数分组,Q_(1)组(24560名):AIP<-0.56;Q_(2)组(24925名):-0.56≤AIP<-0.16;Q_(3)组(24653名):-0.16≤AIP<0.31;Q_(4)组(24737名):AIP≥0.31。采用寿命表法计算心肌梗死的累积发病率,并采用log-rank检验进行组间比较;采用多因素Cox回归分析AIP对AMI发生的影响。结果在平均随访(12.9±1.0)年后,共有1804例研究对象发生AMI。随AIP四分位数分组递增,AMI累积发病率呈递增趋势,分别为1.23%、1.47%、2.11%和2.47%(P<0.001)。在校正年龄、性别、文化程度、体育锻炼、家庭人均月收入、吸烟、饮酒、卒中病史、是否服用降压药、降糖药、收缩压、体质指数、总胆固醇、空腹血糖、血尿酸、C反应蛋白等混杂因素后,多因素Cox回归分析结果显示,AIP每增加一个标准差(0.68),AMI发生的风险增加30%(HR=1.30,95%CI:1.21~1.41,P<0.001);与Q_(1)组比较,Q_(3)组和Q_(4)组发生AMI的风险分别增加了46%(HR=1.46,95%CI:1.24~1.71,P<0.001)和70%(HR=1.70,95%CI:1.45~1.99,P<0.001),但Q_(2)组发生AMI的风险并未显著增加(HR=1.15,95%CI:0.97~1.35,P=0.11)。结论开滦队列研究数据显示,AIP增加是AMI发生的独立危险因子。Objective To investigate the clinical value of atherogenic index of plasma(AIP)on the occurrence of acute myocardial infarction(AMI)and evaluate its predictive value.Methods This was a prospective cohort study.A total of 98875 employees of Kailuan Group Company who had no previous history of myocardial infarction from July 2006 to October 2007 were selected as the observation cohort and followed up until 31 December 2019.Baseline data was recorded and new AMI was used as the endpoint event.All participants were divided into four quartile groups according to the AIP.Q_(1) group(n=24560):AIP<-0.56;Q_(2) group(n=24925):-0.56≤AIP<-0.16;Q_(3) group(n=24653):-0.16≤AIP<0.31;Q_(4) group(n=24737):AIP≥0.31.The cumulative incidence of myocardial infarction was calculated using the lifetime table method and compared between four groups using the log-rank test.Multivariate Cox regression was used to analyze the effect of AIP on the occurrence of AMI.Results A total of 1804 study participants occurred AMI after the mean follow-up 12.9±1.0 years.With the increase of AIP quartile grouping,the cumulative incidence of AMI showed an increasing trend,1.23%,1.47%,2.11%and 2.47%in four groups respectively(P<0.001).After adjusting for age,gender,educational level,physical exercise,family per capita monthly income,smoking,alcohol consumption,medical history of stroke,whether to take antihypertensive drugs,hypoglycemic drugs,systolic blood pressure,body mass index,total cholesterol,fasting blood glucose,blood uric acid,and C reactive protein,Cox regression analysis results showed that HR for AIP was 1.30(95%CI:1.21-1.41,P<0.001),which meant one standard deviation increase by AIP(0.68),the risk of AMI was increased by 30%.Compared with the Q_(1) group,the risk of AMI in the Q_(3) group and Q_(4) group increased 46%(HR=1.46,95%CI:1.24-1.71,P<0.001)and 70%(HR=1.70,95%CI:1.45-1.99,P<0.001).However,the risk of AMI was not significantly increased in the Q_(2) group(HR=1.15,95%CI:0.97-1.35,P=0.11).Conclusions Data from the Kailuan cohort

关 键 词：急性心肌梗死 动脉粥样硬化 血浆致动脉粥样硬化指数 预测价值 

分 类 号：R542.22[医药卫生—心血管疾病]