Yang Lijiao, Wang Hong, Zhang Yida, Han Tingting, Wang Wenfeng
1 Department of Cardiology, Affiliated Hospital of Chengde Medical College, Chengde, Hebei Province, China.
Clin Appl Thromb Hemost. 2018 Jul;24(5):822-827. doi: 10.1177/1076029617737837. Epub 2017 Nov 9.
Lipoprotein-associated phospholipase A (Lp-PLA) is an independent risk factor for cardiovascular disease. Accordingly, studies from many countries around the world have shown an association between Lp-PLA and cardiovascular events in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI), but this association has not been documented among the Chinese. The aim of this study was to assess the use of Lp-PLA as a useful marker for predicting the long-term prognosis of Chinese patients with ACS undergoing PCI. A total of 651 consecutive patients undergoing PCI between September 2013 and January 2015 were divided into 2 groups: the high Lp-PLA group (n = 262, Lp-PLA > 138 nmol/L) and the low Lp-PLA group (n = 389, Lp-PLA ≤ 138 nmol/L). The end point was all-cause mortality and rehospitalization. The median follow-up was 24 months. Multivariate analysis showed that high Lp-PLA was an independent predictor of all-cause mortality and rehospitalization (hazard ratio: 1.429, 95% confidence interval [CI]: 1.411-1.448; P < .05). The Lp-PLA had good accuracy for predicting all-cause mortality and rehospitalization among patients with ACS undergoing PCI (area under the receiver-operating characteristic curve: 0.858, 95% CI: 0.819-0.898; P < .05), and a good correlation with the Global Registry of Acute Coronary Event score ( r = 0.525, P < .05). This study provided evidence that Lp-PLA could predict all-cause mortality and rehospitalization risk among patients with ACS undergoing PCI.
脂蛋白相关磷脂酶A(Lp-PLA)是心血管疾病的独立危险因素。因此,世界上许多国家的研究表明,Lp-PLA与接受经皮冠状动脉介入治疗(PCI)的急性冠状动脉综合征(ACS)患者的心血管事件之间存在关联,但在中国人群中尚未有此关联的记录。本研究的目的是评估Lp-PLA作为预测接受PCI的中国ACS患者长期预后的有用标志物的价值。2013年9月至2015年1月期间连续接受PCI的651例患者被分为两组:高Lp-PLA组(n = 262,Lp-PLA> 138 nmol/L)和低Lp-PLA组(n = 389,Lp-PLA≤138 nmol/L)。终点为全因死亡率和再次住院率。中位随访时间为24个月。多变量分析显示,高Lp-PLA是全因死亡率和再次住院的独立预测因素(风险比:1.429,95%置信区间[CI]:1.411 - 1.448;P <.05)。Lp-PLA在预测接受PCI的ACS患者的全因死亡率和再次住院率方面具有良好的准确性(受试者工作特征曲线下面积:0.858,95% CI:0.819 - 0.898;P <.05),并且与急性冠状动脉事件全球注册评分具有良好的相关性(r = 0.525,P <.05)。本研究提供了证据表明Lp-PLA可以预测接受PCI的ACS患者的全因死亡率和再次住院风险。