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血清脂蛋白（a）水平与钙化性主动脉瓣狭窄严重程度及预后的关联：一项中国队列研究

Association of serum lipoprotein(a) level with the severity and prognosis of calcific aortic valve stenosis: a Chinese cohort study.

作者信息

Liu Shuo-Lin, Rozi Rynat, Shi Hui-Wei, Gao Ying, Guo Yuan-Lin, Tang Yi-Da, Li Jian-Jun, Wu Na-Qiong

机构信息

Endocrinology & Cardiometabolic Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

J Geriatr Cardiol. 2020 Mar;17(3):133-140. doi: 10.11909/j.issn.1671-5411.2020.03.009.

DOI:10.11909/j.issn.1671-5411.2020.03.009
PMID:32280329
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7118012/
Abstract

BACKGROUND

There was a causal relationship between elevated lipoprotein(a) [Lp(a)] levels and increased risk of calcific aortic valve stenosis (CAVS) in whites and blacks. The present study aimed to investigate whether Lp(a) levels were associated with aortic stenosis (AS) severity and clinical events in Chinese patients.

METHODS

Levels of serum Lp(a) were measured in 652 patients with CAVS, whom all underwent baseline echocardiographic examination. The clinical endpoint was defined as a composite of aortic valve replacement (AVR) and cardiac death.

RESULTS

Patients in the tertile 3 of Lp(a) had a higher percentage of severe AS compared with those in the tertile 1 and 2 of Lp(a) (46.2% 33.9%, = 0.005). Moreover, the top tertile of Lp(a) was an independent predictor of severe AS (OR = 1.78, 95% CI: 1.18-2.66, = 0.006). However, there was no significant association between tertile 3 of Lp(a) and clinical events (hazard ratio: 0.73; 95% CI: 0.43-1.24; = 0.239) in the multivariate Cox regression analysis during a mean follow-up time of 3.16 ± 2.74 years.

CONCLUSIONS

Elevated Lp(a) level was an independent predictor of severe AS by echocardiography in the Chinese population, but was not associated with the increased risk of AVR and cardiac death, suggesting that Lp(a) levels might be helpful in the risk stratification of patients with CAVS.

摘要

背景

在白人和黑人中，脂蛋白(a)[Lp(a)]水平升高与钙化性主动脉瓣狭窄(CAVS)风险增加之间存在因果关系。本研究旨在调查Lp(a)水平与中国患者主动脉狭窄(AS)严重程度及临床事件是否相关。

方法

对652例CAVS患者进行血清Lp(a)水平检测，所有患者均接受了基线超声心动图检查。临床终点定义为主动脉瓣置换(AVR)和心源性死亡的复合终点。

结果

与Lp(a)处于第一和第二三分位数的患者相比，Lp(a)处于第三三分位数的患者重度AS的比例更高(46.2%对33.9%，P=0.005)。此外，Lp(a)最高三分位数是重度AS的独立预测因素(OR=1.78，95%CI：1.18-2.66，P=0.006)。然而，在平均随访时间为3.16±2.74年的多变量Cox回归分析中，Lp(a)第三三分位数与临床事件之间无显著相关性(风险比：0.73；95%CI：0.43-1.24；P=0.239)。

结论

在中国人群中，Lp(a)水平升高是经超声心动图诊断的重度AS的独立预测因素，但与AVR和心源性死亡风险增加无关，这表明Lp(a)水平可能有助于CAVS患者的风险分层。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/165f/7118012/737c579a40e8/jgc-17-03-133-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/165f/7118012/73549122fe54/jgc-17-03-133-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/165f/7118012/8d173fe9a41b/jgc-17-03-133-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/165f/7118012/92c8aa82ddf1/jgc-17-03-133-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/165f/7118012/575f685c9537/jgc-17-03-133-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/165f/7118012/737c579a40e8/jgc-17-03-133-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/165f/7118012/73549122fe54/jgc-17-03-133-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/165f/7118012/8d173fe9a41b/jgc-17-03-133-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/165f/7118012/92c8aa82ddf1/jgc-17-03-133-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/165f/7118012/575f685c9537/jgc-17-03-133-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/165f/7118012/737c579a40e8/jgc-17-03-133-g005.jpg

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