Yin Yun-Jie, Chen Yan-Chun, Xu Liang, Zhao Xiang-Hai
Department of Cardiology, Yixing People's Hospital, Yixing, Jiangsu Province 214200, PR China.
Int J Cardiol Heart Vasc. 2020 May 26;28:100541. doi: 10.1016/j.ijcha.2020.100541. eCollection 2020 Jun.
Percutaneous coronary intervention (PCI) is one of the dominant methods for revascularization in patients with coronary heart disease (CHD). However, periprocedural myocardial injury (PMI) is a frequent complication following PCI and is known to be a predictor of postprocedural cardiovascular morbidity and mortality. Although several studies try to identify serum markers to predict the PMI, there is a little information about the role of lipoprotein-associated phospholipase A2 (Lp-PLA2) as a predictor of PMI. Therefore, we aimed to investigate the relationship of Lp-PLA2 levels and PMI in patients undergoing elective PCI.
This study included 265 consecutive patients with normal preprocedural cardiac troponin T(cTNT) who received elective PCI. The samples for cTNT were collected at 8, 16, and 24 h after PCI to assess perioperative myocardial injury. The Lp-PLA2 and other serum lipid parameters were measured after 12 fasting hours before PCI.
The data suggested that the patients with preprocedural high Lp-PLA2 were strongly and independently correlated with the risk of PMI. Pearson correlation analysis showed that preprocedural Lp-PLA2 was significantly positively correlated with postprocedural cTnT elevation ( = 0.694, < 0.05). Binary logistic regression analysis was used to analyze the risk factors of PMI, we found that Lp-PLA2 was independent risk factor for postprocedural cTnT elevation. The area under Receiver Operating Characteristic curve of Lp-PLA2 was 0.757 ( 0.692 ~ 0.821, < 0.001), the best cut-off point was 185 ng/ml, sensitivity and specificity were 65.33% and 76.32%.
Our study demonstrated that preprocedural Lp-PLA2 was associated with postprocedural cTnT elevation and was the independent risk factor of PMI.
经皮冠状动脉介入治疗（PCI）是冠心病（CHD）患者血运重建的主要方法之一。然而，围手术期心肌损伤（PMI）是PCI术后常见的并发症，并且已知是术后心血管发病和死亡的预测指标。尽管多项研究试图确定预测PMI的血清标志物，但关于脂蛋白相关磷脂酶A2（Lp-PLA2）作为PMI预测指标的作用的信息较少。因此，我们旨在研究择期PCI患者中Lp-PLA2水平与PMI的关系。
本研究纳入了265例连续接受择期PCI且术前心肌肌钙蛋白T（cTNT）正常的患者。在PCI术后8、16和24小时采集cTNT样本，以评估围手术期心肌损伤。在PCI术前禁食12小时后测量Lp-PLA2和其他血脂参数。
数据表明，术前Lp-PLA2水平高的患者与PMI风险密切且独立相关。Pearson相关性分析显示，术前Lp-PLA2与术后cTnT升高显著正相关（r = 0.694，P < 0.05）。采用二元逻辑回归分析PMI的危险因素，我们发现Lp-PLA2是术后cTnT升高的独立危险因素。Lp-PLA2的受试者工作特征曲线下面积为0.757（95%CI：0.692~0.821，P < 0.001），最佳截断点为185 ng/ml，敏感性和特异性分别为65.33%和76.32%。
我们的研究表明，术前Lp-PLA2与术后cTnT升高相关，是PMI的独立危险因素。
