Matsumoto Ichiro, Misaki Atsushi, Kurozumi Mizuki, Nanba Tsunetatsu, Takagi Yuichiro
Cardiovascular Center, KKR Takamatsu Hospital, Takamatsu, Japan.
Cardiovascular Center, KKR Takamatsu Hospital, Takamatsu, Japan.
J Cardiol. 2018 Jan;71(1):10-15. doi: 10.1016/j.jjcc.2017.07.012. Epub 2017 Sep 12.
Some studies have demonstrated that low-density lipoprotein cholesterol (LDL-C) lowering therapy is one of the most important strategies to prevent coronary artery disease. Also, serum triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C) are recognized as independent risk factors of cardiovascular diseases. The aim of this study was to investigate whether the nonfasting TG/HDL-C ratio could affect the incidence of cardiovascular events after percutaneous coronary intervention (PCI) even in patients treated with statins.
One thousand one hundred seventy consecutive patients were enrolled, all of whom underwent successful PCI for acute coronary syndrome or stable angina and continued statin treatments after PCI. They were equally divided into three groups on the basis of a nonfasting TG/HDL-C ratio 3 months after PCI. Among these groups, the incidence of major adverse cardiac events (MACE) was measured during a maximum of 5 years after PCI. MACE was defined as cardiac death, nonfatal myocardial infarction, revascularization due to new stenosis or restenosis. Kaplan-Meier analysis demonstrated that patients with higher TG/HDL-C ratio had a significantly higher incidence of MACE than other groups (p<0.001). In addition, Cox proportional hazards regression analysis indicated that the nonfasting TG/HDL-C ratio was significantly correlated with the incidence of MACE.
The nonfasting TG/HDL-C ratio was a valuable predictor of cardiovascular events after PCI in patients treated with statins.
一些研究表明，降低低密度脂蛋白胆固醇（LDL-C）治疗是预防冠状动脉疾病的最重要策略之一。此外，血清甘油三酯（TG）和高密度脂蛋白胆固醇（HDL-C）被认为是心血管疾病的独立危险因素。本研究的目的是调查即使在接受他汀类药物治疗的患者中，非空腹TG/HDL-C比值是否会影响经皮冠状动脉介入治疗（PCI）后心血管事件的发生率。
连续纳入1170例患者，所有患者均因急性冠状动脉综合征或稳定型心绞痛成功接受PCI治疗，并在PCI术后继续接受他汀类药物治疗。根据PCI术后3个月的非空腹TG/HDL-C比值将他们平均分为三组。在这些组中，在PCI术后最长5年期间测量主要不良心脏事件（MACE）的发生率。MACE定义为心源性死亡、非致命性心肌梗死、因新狭窄或再狭窄导致的血运重建。Kaplan-Meier分析表明，TG/HDL-C比值较高的患者MACE发生率明显高于其他组（p<0.001）。此外，Cox比例风险回归分析表明，非空腹TG/HDL-C比值与MACE发生率显著相关。
在接受他汀类药物治疗的患者中，非空腹TG/HDL-C比值是PCI术后心血管事件的有价值预测指标。
