外周动脉疾病患者的冠状动脉疾病严重程度与心血管生物标志物
Coronary Artery Disease Severity and Cardiovascular Biomarkers in Patients with Peripheral Artery Disease.
作者信息
Hikita Hiroyuki, Shigeta Takatoshi, Kimura Shigeki, Takahashi Atsushi, Isobe Mitsuaki
机构信息
Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan.
Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
出版信息
Int J Angiol. 2015 Dec;24(4):278-82. doi: 10.1055/s-0035-1555133. Epub 2015 Jun 26.
Cardiovascular mortality in peripheral artery disease (PAD) patients is higher in critical limb ischemia (CLI) than in intermittent claudication (IC). We sought to evaluate differential characteristics of coronary artery disease (CAD) severity and prognostic biomarkers for cardiovascular events between CLI and IC patients. Coronary angiography was performed on 242 PAD patients (age 73 ± 8 years) with either CLI or IC. High-sensitivity troponin T (hs-TnT), eicosapentaenoic acid-arachidonic acid ratio (EPA/AA), and lipoprotein(a), as biomarkers for prognostic factors, were measured from blood samples. The study patients were divided into a CLI-group (n = 42) and IC-group (n = 200). The Gensini score as an indicator of coronary angiographic severity was higher in the CLI-group than in the IC-group (39.1 ± 31.2 vs. 8.5 ± 8.3, p < 0.0001). Hs-TnT and lipoprotein(a) values were higher in the CLI-group than in the IC-group (0.152 ± 0.186 ng/mL vs. 0.046 ± 0.091, p < 0.0001, 45.9 ± 23.3 mg/dL vs. 26.2 ± 27.7, p = 0.0002, respectively) and EPA/AA was lower in the CLI-group than in the IC-group (0.22 ± 0.11 vs. 0.38 ± 0.29, p = 0.0049, respectively). Greater CAD severity, higher hs-TnT, and lipoprotein(a), and lower EPA/AA were observed in the CLI-group, which may explain higher cardiovascular events in patients with CLI.
外周动脉疾病(PAD)患者中,严重肢体缺血(CLI)患者的心血管死亡率高于间歇性跛行(IC)患者。我们试图评估CLI和IC患者之间冠状动脉疾病(CAD)严重程度的差异特征以及心血管事件的预后生物标志物。对242例患有CLI或IC的PAD患者(年龄73±8岁)进行了冠状动脉造影。从血液样本中测量了高敏肌钙蛋白T(hs-TnT)、二十碳五烯酸-花生四烯酸比值(EPA/AA)和脂蛋白(a)作为预后因素的生物标志物。研究患者分为CLI组(n = 42)和IC组(n = 200)。作为冠状动脉造影严重程度指标的Gensini评分在CLI组高于IC组(39.1±31.2 vs. 8.5±8.3,p < 0.0001)。CLI组的hs-TnT和脂蛋白(a)值高于IC组(分别为0.152±0.186 ng/mL vs. 0.046±0.091,p < 0.0001;45.9±23.3 mg/dL vs. 26.2±27.7,p = 0.0002),而CLI组的EPA/AA低于IC组(分别为0.22±0.11 vs. 0.38±0.29,p = 0.0049)。CLI组观察到更严重的CAD、更高的hs-TnT和脂蛋白(a)以及更低的EPA/AA,这可能解释了CLI患者心血管事件发生率更高的原因。