Que Bin, Wang Chunmei, Ai Hui, Zhang Xinyong, Wang Mei, Nie Shaoping
Emergency and Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing 100029, China.
Stem Cells Int. 2016;2016:6175948. doi: 10.1155/2016/6175948. Epub 2016 Jan 6.
Background. The present study aimed to evaluate the prevalence and prognosis of residual lipid abnormalities in statin-treated acute coronary syndrome (ACS) patients after percutaneous coronary intervention (PCI). Subjects and Methods. A total of 3,047 ACS patients who underwent PCI and received statin therapy were included. Plasma concentrations of LDL-C, HDL-C, and TG were measured. For the follow-up study, major adverse cardiovascular cerebrovascular events (MACCE; including total death, cardiovascular death, myocardial infarction, and revascularization) were documented. Results. A total of 93.14% of all individuals were followed up for 18.1 months (range, 0-29.3 months). Of all 3,047 patients, those with a suboptimal goal were 67.75%, 85.85%, and 33.64% for LDL-C, HDL-C, and TG levels, respectively. Multiple Cox regression analysis revealed there were significant increases in cumulative MACCE of 41% (HR = 1.41, 95% CI [1.09-1.82], p = 0.008), and revascularization of 48% (HR = 1.48, 95% CI [1.10-1.99], p = 0.01) in low HDL-C patients with ACS after PCI, but not the high TG group at the end of study. Conclusions. Our results showed there is high rate of dyslipidemia in Chinese ACS patients after PCI. Importantly, low HDL-C but not high TG levels are associated with higher MACCE and revascularization rates in ACS patients after PCI.
背景。本研究旨在评估经皮冠状动脉介入治疗（PCI）后接受他汀类药物治疗的急性冠状动脉综合征（ACS）患者残留脂质异常的患病率和预后。
对象与方法。共纳入3047例接受PCI并接受他汀类药物治疗的ACS患者。测量血浆低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）和甘油三酯（TG）浓度。在随访研究中，记录主要不良心血管脑血管事件（MACCE；包括全因死亡、心血管死亡、心肌梗死和血运重建）。
结果。所有个体中有93.14%接受了18.1个月的随访（范围为0 - 29.3个月）。在所有3047例患者中，LDL-C、HDL-C和TG水平未达理想目标的患者分别占67.75%、85.85%和33.64%。多因素Cox回归分析显示，PCI术后ACS伴低HDL-C患者的累积MACCE显著增加41%（HR = 1.41，95%CI[1.09 - 1.82]，p = 0.008），血运重建增加48%（HR = 1.48，95%CI[1.10 - 1.99]，p = 0.01），但在研究结束时高TG组未出现此情况。
结论。我们的结果表明，中国PCI术后ACS患者的血脂异常发生率较高。重要的是，低HDL-C而非高TG水平与PCI术后ACS患者较高的MACCE和血运重建率相关。
