Center for Cardiovascular Diseases, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, Guangdong, China (mainland).
Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, Guangdong, China (mainland).
Med Sci Monit. 2018 Jun 18;24:4154-4161. doi: 10.12659/MSM.907400.
BACKGROUND Periprocedural myocardial injury (PMI) is known to be a predictor of postprocedural cardiovascular morbidity and mortality following a percutaneous coronary intervention (PCI). However, the correlation between low-density lipoprotein cholesterol and periprocedural myocardial injury in patients following elective PCI in southern China remains unclear. Therefore, we aimed to investigate the association of preoperative low-density lipoprotein cholesterol (LDL-C) levels with PMI in patients following elective PCI. MATERIAL AND METHODS This study included 1942 consecutive patients who received elective PCI. Cardiac troponin I (cTnI) was used to assess perioperative myocardial injury. The peak cTnI was measured within 24 h after PCI, and the correlation between the cTnI value and the preoperative LDL level was studied. RESULTS The data suggest that the PCI patients with preprocedural LDL-C <100 mg/dl were strongly and independently correlated with less risk of PMI. Univariate logistic regression indicated that patients with preprocedural LDL-C of 70~99 mg/dl were correlated with lower risk of postprocedural cTnI elevation above 3×ULN (odds ratio [OR]: 0.762; 95% [CI]: 0.603-0.965; P<0.024) up to 20×ULN (OR: 0.730; 95% CI: 0.576-0.924; P<0.000) compared to those with preprocedural LDL-C ≥100 mg/dl. Moreover, patients with preprocedural LDL-C of <70 mg/dl were more strongly correlated with lower risk of postprocedural cTnI elevation above 3×ULN (OR: 0.641; 95% CI: 0.436-0.936; P<0.021) up to 20×ULN (OR: 0.476; 95% CI: 0.316-0.717; P<0.000). CONCLUSIONS Our study demonstrated that PCI patients with lower preprocedural LDL-C were correlated with a lower risk of PMI in southern China.
经皮冠状动脉介入治疗(PCI)后,围手术期心肌损伤(PMI)已知是术后心血管发病率和死亡率的预测因素。然而,在中国南方,接受选择性 PCI 的患者的低密度脂蛋白胆固醇(LDL-C)与围手术期心肌损伤之间的相关性仍不清楚。因此,我们旨在研究选择性 PCI 后患者术前 LDL-C 水平与 PMI 的关系。
本研究纳入了 1942 例接受选择性 PCI 的连续患者。心肌肌钙蛋白 I(cTnI)用于评估围手术期心肌损伤。PCI 后 24 小时内测量 cTnI 峰值,研究 cTnI 值与术前 LDL 水平之间的相关性。
数据表明,术前 LDL-C<100mg/dl 的 PCI 患者与 PMI 风险降低强烈相关。单因素 logistic 回归表明,术前 LDL-C 为 70~99mg/dl 的患者与术后 cTnI 升高至 3×ULN(优势比 [OR]:0.762;95%[CI]:0.603-0.965;P<0.024)至 20×ULN(OR:0.730;95%CI:0.576-0.924;P<0.000)的风险较低相关。此外,术前 LDL-C<70mg/dl 的患者与术后 cTnI 升高至 3×ULN(OR:0.641;95%CI:0.436-0.936;P<0.021)至 20×ULN(OR:0.476;95%CI:0.316-0.717;P<0.000)的风险较低相关。
我们的研究表明,中国南方接受 PCI 的患者术前 LDL-C 较低与 PMI 风险降低相关。