Maor Elad, Fefer Paul, Varon David, Rosenberg Nurit, Levi Nitza, Hod Hanoch, Matetzky Shlomi
Leviev Heart Institute, Sheba Medical Center, 52621, Tel Hashomer, Israel,
J Thromb Thrombolysis. 2015 May;39(4):474-80. doi: 10.1007/s11239-014-1166-2.
The prevalence of thrombophilia and dyslipidemia among young survivors of acute coronary syndrome has not been clearly defined. The purpose of the current study was to investigate the prevalence of multiple markers of thrombophilia and dyslipidemia in a cohort of consecutive young survivors of acute coronary syndrome. The study cohort included 156 consecutive young patients (men <45 and women <50 years), admitted to the intensive cardiac care unit with newly diagnosed acute coronary syndrome. Analysis included baseline, clinical and epidemiological characteristics, angiographic coronary anatomy, echocardiographic evaluation, extensive lipid and thrombophilia laboratory profiles, and in-hospital and 1-year clinical outcomes for all patients. Acute myocardial infarction was diagnosed in 142 (92 %) patients, of whom 108 (72 %) had ST-segment elevation. Eighteen (12 %) patients had no traditional risk factors. Low levels of high-density lipoprotein (<40 mg/dL) were found in 101 (65 %) patients, and 49 (34 %) patients had elevated levels of lipoprotein(a) (Lp(a)) (>30 mg/dL). Eighteen (12 %) patients were diagnosed with antiphospholipid antibody syndrome (APS), and 73 (47 %) had at least one laboratory finding consistent with thrombophilia. Patients with APS had significantly higher levels of Lp(a) (46 ± 32 vs. 29 ± 31 mg/dL, p = 0.005). APS is a common prothrombotic state found in young survivors of acute coronary syndrome. Lp(a) levels are elevated among APS patients who present with premature acute coronary syndrome.
急性冠脉综合征年轻幸存者中血栓形成倾向和血脂异常的患病率尚未明确界定。本研究的目的是调查一组急性冠脉综合征年轻连续幸存者中多种血栓形成倾向和血脂异常标志物的患病率。研究队列包括156例连续的年轻患者（男性<45岁，女性<50岁），因新诊断的急性冠脉综合征入住心脏重症监护病房。分析包括所有患者的基线、临床和流行病学特征、冠状动脉造影解剖结构、超声心动图评估、广泛的血脂和血栓形成倾向实验室检查结果以及住院期间和1年的临床结局。142例（92%）患者诊断为急性心肌梗死，其中108例（72%）出现ST段抬高。18例（12%）患者无传统危险因素。101例（65%）患者高密度脂蛋白水平低（<40mg/dL），49例（34%）患者脂蛋白(a)（Lp(a)）水平升高（>30mg/dL）。18例（12%）患者诊断为抗磷脂抗体综合征（APS），73例（47%）至少有一项实验室检查结果符合血栓形成倾向。APS患者的Lp(a)水平显著更高（46±32 vs. 29±31mg/dL，p=0.005）。APS是急性冠脉综合征年轻幸存者中常见的促血栓形成状态。在出现早发性急性冠脉综合征的APS患者中Lp(a)水平升高。
