Center for Vascular Surgery and Interventional Radiology, Tampere University Hospital, Tampere, Finland.
Department of Cardio-Thoracic Surgery, Heart Hospital, Tampere University Hospital, Tampere, Finland.
Scand J Clin Lab Invest. 2020 Sep;80(5):370-374. doi: 10.1080/00365513.2020.1746974. Epub 2020 Jun 3.
Coronary artery and peripheral artery diseases represent different clinical outcomes of atherosclerosis and despite sharing common risk factors the ultimate reasons determining disease presentation are still unclear. The present study sought to define and compare the serum lipid and apolipoprotein profiles of patients undergoing coronary artery bypass grafting and those treated invasively for symptomatic lower extremity peripheral artery disease. Altogether 218 coronary and 280 peripheral artery disease patients treated between 2013 and 2014 in the Tampere University Hospital, Tampere, Finland, with available lipid measurements within two years prior to the intervention were retrospectively analysed. The Extended Friedewald formula neural network model was used to obtain apolipoprotein and lipoprotein subfraction values. Patients undergoing coronary artery bypass surgery had a clear male predominance (82% versus 53%, < 0.001), lower median age (69 versus 74 years, < 0.001) and a lower prevalence of smoking (18% versus 32%, = 0.001) and pulmonary disease (12% versus 20%, = 0.023) compared to peripheral artery disease patients. There were some differences in the serum lipid profiles between the study groups in the univariable analyses. When controlling for the statistically significant differences in age, sex, urgency of treatment and comorbidities between the groups in a multivariable logistic regression model, higher serum concentrations of apolipoprotein A-I were significantly and independently associated with coronary artery disease (OR 1.11 for 0.01 g/L increase, = 0.044). In conclusion, patients undergoing coronary artery bypass grafting appear to have higher apolipoprotein A-I levels when compared to patients treated for peripheral artery disease.
冠状动脉和外周动脉疾病代表了动脉粥样硬化的不同临床结果，尽管它们具有共同的危险因素，但决定疾病表现的最终原因仍不清楚。本研究旨在定义和比较接受冠状动脉旁路移植术和接受有症状的下肢外周动脉疾病侵袭性治疗的患者的血清脂质和载脂蛋白谱。总共回顾性分析了 2013 年至 2014 年期间在芬兰坦佩雷大学医院接受治疗的 218 例冠状动脉疾病和 280 例外周动脉疾病患者，这些患者在干预前两年内有可用的脂质测量值。使用扩展的 Friedewald 公式神经网络模型获得载脂蛋白和脂蛋白亚组分值。接受冠状动脉旁路手术的患者具有明显的男性优势（82%比 53%， < 0.001），中位年龄更低（69 比 74 岁， < 0.001），吸烟（18%比 32%， = 0.001）和肺病（12%比 20%， = 0.023）的患病率较低。在单变量分析中，两组之间的血清脂质谱存在一些差异。在校正了组间年龄、性别、治疗紧迫性和合并症的统计学差异后，在多变量逻辑回归模型中，血清载脂蛋白 A-I 浓度升高与冠状动脉疾病显著相关（每增加 0.01 g/L，OR 1.11， = 0.044）。总之，与接受外周动脉疾病治疗的患者相比，接受冠状动脉旁路移植术的患者的载脂蛋白 A-I 水平似乎更高。
