Han Y, Yang C K, Gao C Y, Liu Y H, Cheng J T, Wang X P, Wang Z M, Wu X J, Xu C Y
Department of Cardiology, People's Hospital of Henan Province, Zhengzhou 450003, China.
Zhonghua Yi Xue Za Zhi. 2019 May 21;99(19):1490-1493. doi: 10.3760/cma.j.issn.0376-2491.2019.19.011.
To investigate the relationship between Lipoprotein (LP) (a) level and the characteristics of tissue components of left main coronary artery (LMCA) plaque. A total of 102 patients with stable angina pectoris who underwent percutaneous coronary intervention (PCI) in the People's Hospital of Henan Province from June 2010 to October 2016 were included. We performed intravascular ultrasound-virtual histology (IVUS-VH) to their LMCAs and evaluated the tissue characteristics, and the blood level of total cholesterol (TC), triacylglycerol (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), ApoB, ApoA1, LP(a) were measured. According to the value of their LP(a) level they were divided into 2 groups (high LP(a) group (>300 mg/L) (=35) and low LP(a) group (≤300 mg/L) (=67)), then the relationship between the above lipid values and the tissue characteristics of the LMCA plaque in the patients were evaluated. Patients with a high LP(a) had a larger percentage of fibrolipid volume and a smaller percentage fibrous volume compared to patients with a normal LP(a) (25%±5% vs 13%±6%, <0.01 and 50%±8% vs 61%±9%, <0.01). Using multivariate linear regression analysis after adjustment for the above-mentioned confounding factors, LP(a) had a significantly positive correlation with fibrolipid volume percentage (=0.645, =0.29, <0.01), and had a negative correlation with fibrous volume percentage (=-0.467, =-0.32,<0.01), suggesting that the LP(a) was associated with the vulnerability of the LMCA plaque. For the patients with stable angina pectoris, the LP(a) has a significantly positive correlation with the percentage of fibrolipid volume and a negative correlation with the percentage of fibrous volume, suggesting that the LP(a) could predict the vulnerability of the LMCA plaque.
探讨脂蛋白（LP）（a）水平与左主干冠状动脉（LMCA）斑块组织成分特征之间的关系。纳入2010年6月至2016年10月在河南省人民医院接受经皮冠状动脉介入治疗（PCI）的102例稳定型心绞痛患者。对其左主干冠状动脉进行血管内超声虚拟组织学（IVUS-VH）检查并评估组织特征，同时检测总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、载脂蛋白B（ApoB）、载脂蛋白A1（ApoA1）、LP（a）的血药浓度。根据LP（a）水平将患者分为2组（高LP（a）组（>300mg/L）（=35例）和低LP（a）组（≤300mg/L）（=67例）），然后评估上述血脂值与患者LMCA斑块组织特征之间的关系。与LP（a）正常的患者相比，LP（a）高的患者纤维脂质体积百分比更大，纤维体积百分比更小（25%±5%对13%±6%，<0.01；50%±8%对61%±9%，<0.01）。在对上述混杂因素进行校正后，采用多因素线性回归分析，LP（a）与纤维脂质体积百分比呈显著正相关（=0.645，=0.29，<0.01），与纤维体积百分比呈负相关（=-0.467，=-0.32，<0.01），提示LP（a）与LMCA斑块的易损性有关。对于稳定型心绞痛患者，LP（a）与纤维脂质体积百分比呈显著正相关，与纤维体积百分比呈负相关，提示LP（a）可预测LMCA斑块的易损性。
