通过 CT 血管造影术评估低、高密度脂蛋白与冠状动脉斑块组成的关系。
Relationship of low- and high-density lipoproteins to coronary artery plaque composition by CT angiography.
机构信息
Cedars-Sinai Heart Institute and Department of Imaging, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
出版信息
J Cardiovasc Comput Tomogr. 2013 Mar-Apr;7(2):83-90. doi: 10.1016/j.jcct.2013.01.008. Epub 2013 Feb 27.
BACKGROUND
The association between lipoprotein levels and coronary plaque composition is not well understood.
OBJECTIVE
The aim of this prospective international multicenter study of statin-naive individuals was to evaluate the association of low-density lipoprotein (LDL), high-density lipoprotein (HDL), and total cholesterol (TC) to coronary plaque composition by coronary computed tomographic angiography (CTA).
METHODS
We studied 4575 individuals without known coronary artery disease not taking statin medications who underwent coronary CTA. Comparisons were made between those with high versus low LDL, HDL, TC, and non-HDL. We assessed the relationship of lipoproteins and plaques of specific composition (noncalcified [NCP], partially calcified [PCP], or calcified [CP] plaque).
RESULTS
Mean age was 57 ± 11 years (55% men). In univariable analyses, high LDL, low HDL, high TC, and high non-HDL were each associated with increased prevalence of NCPs, PCPs, and CPs (P < 0.05 for all). In multivariable analyses, high non-HDL was associated with the presence of NCP (odds ratio, 1.47; 95% CI, 1.22-1.78: P < 0.001). In the further subanalysis, a weak relationship between the highest group of non HDL (≥190 mg/dL) and the presence of CP was also noted (odds ratio, 1.33; 95% CI, 1.01-1.76; P = 0.04). Further, high non-HDL was associated with increasing numbers of segments with NCP (β coefficient, 0.043; 95% CI, 0.021-0.065; P < 0.001) but not segments with PCP or CP.
CONCLUSION
NCP presence and extent are associated with high non-HDL. These results suggest a relationship between lipid profile and plaque composition.
背景
脂蛋白水平与冠状动脉斑块成分之间的关系尚未得到充分了解。
目的
本项前瞻性国际多中心研究纳入了他汀类药物初治个体，旨在通过冠状动脉 CT 血管造影（CTA）评估低密度脂蛋白（LDL）、高密度脂蛋白（HDL）和总胆固醇（TC）与冠状动脉斑块成分之间的关联。
方法
我们研究了 4575 名未服用他汀类药物且无已知冠状动脉疾病的个体，这些患者均接受了冠状动脉 CTA 检查。比较了 LDL、HDL、TC 和非 HDL 水平高与低的个体之间的差异。评估了脂蛋白与特定组成（非钙化斑块[NCP]、部分钙化斑块[PCP]或钙化斑块[CP]）斑块之间的关系。
结果
平均年龄为 57 ± 11 岁（55%为男性）。在单变量分析中，高 LDL、低 HDL、高 TC 和高非 HDL 均与 NCP、PCP 和 CP 的患病率增加相关（P < 0.05）。在多变量分析中，高非 HDL 与 NCP 的存在相关（比值比，1.47；95%置信区间，1.22-1.78：P < 0.001）。在进一步的亚分析中，还观察到非 HDL 最高组（≥190 mg/dL）与 CP 存在的弱相关性（比值比，1.33；95%置信区间，1.01-1.76；P = 0.04）。此外，高非 HDL 与 NCP 节段数的增加相关（β系数，0.043；95%置信区间，0.021-0.065；P < 0.001），但与 PCP 或 CP 节段数无关。
结论
NCP 的存在和程度与高非 HDL 相关。这些结果表明了血脂谱与斑块组成之间的关系。
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