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高密度脂蛋白胆固醇水平与冠状动脉严重程度相关,但与新发稳定型冠状动脉疾病患者的结局无关。

High-density lipoprotein cholesterol levels are associated with coronary severity but not with outcomes in new-onset patients with stable coronary artery disease.

机构信息

Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No 167 BeiLiShi Road, XiCheng District, Beijing, 100037, China.

Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No 167 BeiLiShi Road, XiCheng District, Beijing, 100037, China.

出版信息

Atherosclerosis. 2017 Aug;263:104-111. doi: 10.1016/j.atherosclerosis.2017.06.013. Epub 2017 Jun 7.

DOI:10.1016/j.atherosclerosis.2017.06.013
PMID:28623739
Abstract

BACKGROUND AND AIMS

The atheroprotective role of high-density lipoprotein cholesterol (HDL-C) levels in coronary artery disease (CAD) remains controversial. This study sought to reappraise the value of HDL-C in predicting the severity and outcomes of new-onset patients with stable CAD in Chinese populations.

METHODS

A total of 4205 new-onset patients with stable CAD who received coronary angiography were enrolled to analyze the relation of HDL-C to coronary severity and major adverse cardiovascular events (MACEs). Coronary severity was evaluated by Gensini scoring system. The MACEs included all-cause death, non-fatal myocardial infarction, stroke, unplanned revascularization and hospitalized unstable angina.

RESULTS

Significantly, HDL-C levels were negatively associated with coronary severity (p < 0.001). During an average of 27.32-month follow-up, 341 (8.12%) MACEs occurred. There was no significant difference of HDL-C levels between events group and non-events group. Furthermore, both Kaplan-Meier and Cox regression analyses found no relationship between HDL-C and cardiovascular outcomes (p > 0.05).

CONCLUSIONS

Plasma HDL-C levels appeared to be a predicator for coronary severity, but it is not associated with clinical outcomes in new-onset, Chinese patients with stable CAD.

摘要

背景与目的

高密度脂蛋白胆固醇(HDL-C)水平在冠状动脉疾病(CAD)中的抗动脉粥样硬化作用仍存在争议。本研究旨在重新评估 HDL-C 在预测中国人群新发稳定 CAD 患者严重程度和结局中的价值。

方法

共纳入 4205 例接受冠状动脉造影的新发稳定 CAD 患者,分析 HDL-C 与冠状动脉严重程度和主要不良心血管事件(MACEs)的关系。冠状动脉严重程度采用 Gensini 评分系统进行评估。MACE 包括全因死亡、非致死性心肌梗死、卒中和计划外血运重建及住院不稳定型心绞痛。

结果

HDL-C 水平与冠状动脉严重程度呈显著负相关(p<0.001)。在平均 27.32 个月的随访期间,发生 341 例(8.12%)MACE。事件组和非事件组的 HDL-C 水平无显著差异。此外,Kaplan-Meier 和 Cox 回归分析均发现 HDL-C 与心血管结局之间无关联(p>0.05)。

结论

血浆 HDL-C 水平似乎是冠状动脉严重程度的预测因子,但与中国新发稳定 CAD 患者的临床结局无关。

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