Department of Cardiovascular Medicine, Xi'an Jiaotong University Medical College First Affiliated Hospital, Xi'an, China.
Department of Cardiovascular Medicine, Xi'an Jiaotong University Medical College First Affiliated Hospital, Xi'an, China
J Investig Med. 2021 Oct;69(7):1310-1317. doi: 10.1136/jim-2021-001803. Epub 2021 May 10.
Recent studies showed that lipoproteins represent major risk factors, both positive and negative, for atherosclerotic cardiovascular disease. The aim of the present study was to describe the relationship between plasma lipid profile and cardiac function and cardiovascular outcomes in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Two independent groups of subjects including a total of 797 patients diagnosed of AMI undergoing PCI admitted to the First Affiliated Hospital of Xi'an Jiaotong University were included in the present study. We performed a cross-sectional study for the correlation between plasma lipid profile and cardiac function based on the first group, including 503 patients with AMI. We further validated the correlation and did the follow-up of 2.4 years of major cardiovascular outcomes on the second group, including 294 patients with AMI. Our results showed that apolipoprotein A-I (ApoA-I) level was significantly reduced, and the high-density lipoprotein cholesterol (HDL-C):ApoA-I ratio was increased in the patients with lower LVEF or higher N-terminal pro-B-type natriuretic peptide levels compared with the control; there was a positive correlation between cardiac function and ApoA-I, and a negative correlation between cardiac function and the HDL-C:ApoA-I ratio. Meanwhile, multivariate Cox analysis showed that ApoA-I was independent predictors of major adverse cardiovascular events (MACEs). Kaplan-Meier survival analysis showed the ApoA-I levels exhibited a significant effect on predicting the incidence of MACEs. In sum, plasma ApoA-I level is positively associated with the cardiac function of patients with AMI after PCI, and ApoA-I is an independent indicator to predict the incidence of MACEs.
最近的研究表明，脂蛋白既是动脉粥样硬化性心血管疾病的主要危险因素（正向和负向）。本研究旨在描述经皮冠状动脉介入治疗（PCI）后急性心肌梗死（AMI）患者的血浆脂质谱与心功能和心血管结局之间的关系。本研究纳入了西安交通大学第一附属医院收治的经 PCI 治疗的共 797 例 AMI 患者的两个独立的受试者组。我们对第一组 503 例 AMI 患者进行了基于血浆脂质谱与心功能相关性的横断面研究。我们进一步验证了相关性，并对第二组 294 例 AMI 患者进行了 2.4 年的主要心血管结局随访。我们的研究结果表明，与对照组相比，LVEF 较低或 N 末端 pro-B 型利钠肽水平较高的患者中载脂蛋白 A-I（ApoA-I）水平显著降低，高密度脂蛋白胆固醇（HDL-C）：ApoA-I 比值升高；心功能与 ApoA-I 呈正相关，心功能与 HDL-C：ApoA-I 比值呈负相关。同时，多变量 Cox 分析表明，ApoA-I 是主要不良心血管事件（MACEs）的独立预测因子。Kaplan-Meier 生存分析表明，ApoA-I 水平对预测 MACEs 的发生率具有显著影响。总之，AMI 患者 PCI 后血浆 ApoA-I 水平与心功能呈正相关，ApoA-I 是预测 MACEs 发生率的独立指标。
