三酰甘油与高密度脂蛋白胆固醇比值对经皮冠状动脉介入治疗后冠心病患者长期死亡率的预测作用：一项回顾性队列研究。
Triglyceride to high-density lipoprotein cholesterol ratio as a predictor of long-term mortality in patients with coronary artery disease after undergoing percutaneous coronary intervention: a retrospective cohort study.
机构信息
Department of Cardiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, People's Republic of China.
Key Laboratory of Cardiac Injury and Repair of Henan Province, Zhengzhou, 450052, People's Republic of China.
出版信息
Lipids Health Dis. 2019 Dec 4;18(1):210. doi: 10.1186/s12944-019-1152-y.
BACKGROUND
It has been confirmed that the triglyceride to high-density lipoprotein cholesterol ratio (THR) is associated with insulin resistance and metabolic syndrome. However, to the best of our knowledge, only a few studies with small sample sizes have investigated the relationship between THR and coronary artery disease (CAD). Therefore, we aimed to assess the correlation between the THR and long-term mortality in patients with CAD after undergoing percutaneous coronary intervention (PCI) in our study that enrolled a large number of patients.
METHODS
A total of 3269 post-PCI patients with CAD were enrolled in the CORFCHD-ZZ study from January 2013 to December 2017. The mean follow-up time was 37.59 ± 22.24 months. Patients were divided into two groups according to their THR value: the lower group (THR < 2.84, n = 1232) and the higher group (THR ≥ 2.84, n = 2037). The primary endpoint was long-term mortality, including all-cause mortality (ACM) and cardiac mortality (CM). The secondary endpoints were major adverse cardiac events (MACEs) and major adverse cardiac and cerebrovascular events (MACCEs).
RESULTS
In our study, ACM occurred in 124 patients: 30 (2.4%) in the lower group and 94 (4.6%) in the higher group (P = 0.002). MACEs occurred in 362 patients: 111 (9.0%) in the lower group and 251 (12.3%) in the higher group (P = 0.003). The number of MACCEs was 482: 152 (12.3%) in the lower group and 320 (15.7%) in the higher group (P = 0.008). Heart failure occurred in 514 patients: 89 (7.2%) in the lower group and 425 (20.9%) in the higher group (P < 0.001). Kaplan-Meier analyses showed that elevated THR was significantly related to long-term ACM (log-rank, P = 0.044) and the occurrence of heart failure (log-rank, P < 0.001). Multivariate Cox regression analyses showed that the THR was an independent predictor of long-term ACM (adjusted HR = 2.042 [1.264-3.300], P = 0.004) and heart failure (adjusted HR = 1.700 [1.347-2.147], P < 0.001).
CONCLUSIONS
An increased THR is an independent predictor of long-term ACM and heart failure in post-PCI patients with CAD.
背景
已经证实甘油三酯与高密度脂蛋白胆固醇的比值（THR）与胰岛素抵抗和代谢综合征有关。然而，据我们所知，只有少数几项样本量较小的研究调查了 THR 与冠状动脉疾病（CAD）之间的关系。因此，我们旨在评估在我们的研究中，THR 与接受经皮冠状动脉介入治疗（PCI）后的 CAD 患者的长期死亡率之间的相关性，该研究纳入了大量患者。
方法
2013 年 1 月至 2017 年 12 月，CORFCHD-ZZ 研究共纳入 3269 例 CAD 行 PCI 术后患者。平均随访时间为 37.59±22.24 个月。根据 THR 值将患者分为两组：低值组（THR<2.84，n=1232）和高值组（THR≥2.84，n=2037）。主要终点是长期死亡率，包括全因死亡率（ACM）和心源性死亡率（CM）。次要终点是主要不良心脏事件（MACEs）和主要不良心脏和脑血管事件（MACCEs）。
结果
本研究中，ACM 发生在 124 例患者中：低值组 30 例（2.4%），高值组 94 例（4.6%）（P=0.002）。MACEs 发生在 362 例患者中：低值组 111 例（9.0%），高值组 251 例（12.3%）（P=0.003）。MACCEs 发生在 482 例患者中：低值组 152 例（12.3%），高值组 320 例（15.7%）（P=0.008）。心力衰竭发生在 514 例患者中：低值组 89 例（7.2%），高值组 425 例（20.9%）（P<0.001）。Kaplan-Meier 分析显示，升高的 THR 与长期 ACM（对数秩，P=0.044）和心力衰竭的发生（对数秩，P<0.001）显著相关。多变量 Cox 回归分析显示，THR 是长期 ACM（调整后的 HR=2.042[1.264-3.300]，P=0.004）和心力衰竭（调整后的 HR=1.700[1.347-2.147]，P<0.001）的独立预测因子。
结论
THR 升高是 CAD 行 PCI 术后患者长期 ACM 和心力衰竭的独立预测因子。
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