Huadu District People's Hospital, Southern Medical University - Cardiology, Guangzhou - China.
Huadu District People's Hospital, Southern Medical University - Intensive Care Unit., Guangzhou - China.
Arq Bras Cardiol. 2019 Jul 18;113(2):197-204. doi: 10.5935/abc.20190120.
Elevated plasma levels of Lipoprotein(a) [Lp(a)] are recognized as a significant risk factor for atherosclerotic vascular disease. However, there are limited data regarding association between Lp(a) and recurrent heart failure (HF) in patients with chronic HF caused by coronary heart disease (CHD).
Elevated levels of Lp(a) might have a prognostic impact on recurrent HF in patients with chronic HF caused by CHD.
A total of 309 patients with chronic HF caused by CHD were consecutively enrolled in this study. The patients were divided into 2 groups according to whether Lp(a) levels were above or below the median level for the entire cohort (20.6 mg/dL): the high Lp(a) group (n = 155) and the low Lp(a) group (n = 154). A 2-sided p < 0.05 was statistically considered significant.
During the median follow-up period of 186 days, 31 cases out of a total of 309 patients (10.03%) could not be reached during follow-up. A Kaplan-Meier analysis demonstrated that patients with higher Lp(a) levels had a higher incidence of recurrent HF than those with lower Lp(a) levels (log-rank < 0.0001). A multivariate Cox regression analysis revealed that Lp(a) levels were independently correlated with the incidence of recurrent HF after adjustment of potential confounders (hazard ratio: 2.720, 95 % confidence interval: 1.730-4.277, p < 0.0001).
In Chinese patients with chronic HF caused by CHD, elevated levels of Lp(a) are independently associated with recurrent HF.
脂蛋白(a) [Lp(a)]的血浆水平升高被认为是动脉粥样硬化性血管疾病的一个重要危险因素。然而，关于冠心病（CHD）引起的慢性心力衰竭（HF）患者的 Lp(a)与复发性 HF 之间的关联，数据有限。
Lp(a)水平升高可能对 CHD 引起的慢性 HF 患者的复发性 HF 有预后影响。
这项研究连续纳入了 309 例 CHD 引起的慢性 HF 患者。根据整个队列的 Lp(a)水平（20.6mg/dL）中位数将患者分为 2 组：高 Lp(a)组（n=155）和低 Lp(a)组（n=154）。双侧 p<0.05 被认为具有统计学意义。
在中位随访 186 天期间，总共 309 例患者中有 31 例（10.03%）在随访期间无法联系到。Kaplan-Meier 分析表明，Lp(a)水平较高的患者复发性 HF 的发生率高于 Lp(a)水平较低的患者（对数秩检验<0.0001）。多变量 Cox 回归分析显示，在校正潜在混杂因素后，Lp(a)水平与复发性 HF 的发生率独立相关（风险比：2.720，95%置信区间：1.730-4.277，p<0.0001）。
在中国 CHD 引起的慢性 HF 患者中，Lp(a)水平升高与复发性 HF 独立相关。
