Amino Mari, Yoshioka Koichiro, Ichikawa Tomohide, Watanabe Eiichi, Kiyono Ken, Nakamura Mari, Sakama Susumu, Ayabe Kengo, Fujii Toshiharu, Hashida Tadashi, Kanda Shigetaka, Tanabe Teruhisa, Ikari Yuji
Department of Cardiovascular Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
Department of Cardiovascular Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
J Electrocardiol. 2019 Mar-Apr;53:71-78. doi: 10.1016/j.jelectrocard.2019.01.003. Epub 2019 Jan 2.
We previously reported that LP positive patients after percutaneous coronary intervention (PCI) had higher rate of re-hospitalization in the small-scale study (135 patients). In this study, we evaluated correlation between LP and later cardiac events leading to re-hospitalization more extensively in greater population.
A 24-h high-resolution (HR) ambulatory electrocardiogram (ECG) was performed in 421 patients that received PCI for the treatment of acute coronary syndrome (ACS) within 30 days. Various baseline characteristics and post-PCI ECG parameters including LP were examined for correlation with later re-hospitalization. LP was evaluated based on 3 different conditions, i.e., the worst, mean and best values, from 24-h signal-averaged QRS wave data. During the post-PCI follow-up period (611 ± 489.0 days), 90 patients were re-hospitalized due to cardiac events. Multivariate analysis identified only positive LP based on the worst value as an independent predictor for re-hospitalization with OR 2.26. Most of re-hospitalization cases (>75%) were predominantly attributed to ischemic events. LP positive population had significantly higher incidences of ischemic events as well as overall re-hospitalization compared to LP negative population. The predictive power of LP was decreased when it was combined with other variables. The receiver operating characteristic analysis determined the LP cut-off values consistent with the LP positive criteria previously reported and standardized.
The presence of LP in the 24-h HR ambulatory ECG post-PCI was an independent predictor for a risk of re-hospitalization due to ischemic cardiac events in ACS patients.
我们之前在一项小规模研究（135例患者）中报告称，经皮冠状动脉介入治疗（PCI）后脂蛋白（LP）阳性的患者再次住院率较高。在本研究中，我们在更大规模的人群中更广泛地评估了LP与导致再次住院的后期心脏事件之间的相关性。
对421例在30天内接受PCI治疗急性冠状动脉综合征（ACS）的患者进行了24小时高分辨率（HR）动态心电图（ECG）检查。检查了包括LP在内的各种基线特征和PCI术后ECG参数与后期再次住院的相关性。根据24小时信号平均QRS波数据，基于3种不同情况（即最差、平均和最佳值）对LP进行评估。在PCI术后随访期（611±489.0天），90例患者因心脏事件再次住院。多因素分析仅将基于最差值的LP阳性确定为再次住院的独立预测因素，比值比为2.26。大多数再次住院病例（>75%）主要归因于缺血性事件。与LP阴性人群相比，LP阳性人群缺血性事件以及总体再次住院的发生率显著更高。当LP与其他变量结合时，其预测能力下降。受试者工作特征分析确定了与先前报告并标准化的LP阳性标准一致的LP截断值。
PCI术后24小时HR动态心电图中LP的存在是ACS患者因缺血性心脏事件再次住院风险的独立预测因素。
