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中国南方地区择期经皮冠状动脉介入治疗患者术前低密度脂蛋白胆固醇与围术期心肌损伤的关系。

Relationship Between Preoperative Low-Density Lipoprotein Cholesterol and Periprocedural Myocardial Injury in Patients Following Elective Percutaneous Coronary Intervention in Southern China.

机构信息

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).

出版信息

Med Sci Monit. 2018 Jun 18;24:4154-4161. doi: 10.12659/MSM.907400.

Abstract

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.

摘要

背景

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。

材料和方法

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。

结果

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。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eaa/6038720/502567223acd/medscimonit-24-4154-g001.jpg

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