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初发急性心肌梗死患者基线血尿酸与 LDL-C 水平变化的相关性研究。

Association between baseline serum uric acid and development of LDL-C level in patients with first acute myocardial infarction.

机构信息

Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang of Jiangxi, 330006, China.

Department of Cardiovascular Medicine, The First Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China.

出版信息

BMC Cardiovasc Disord. 2021 Nov 30;21(1):572. doi: 10.1186/s12872-021-02383-x.

Abstract

BACKGROUND

Data on the relationship of baseline serum uric acid (SUA) with development of low-density lipoprotein cholesterol (LDL-C) level in patients with first acute myocardial infarction (AMI) are limited. The present study is to evaluate whether elevated SUA predicts the development of LDL-C in the first AMI.

METHODS

This is a retrospective 6-month cohort study of 475 hospitalized Chinese patients who underwent first AMI between January 2015 and December 2019 and were reevaluated half a year later at the Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Jiangxi Province, China. The associations of baseline SUA with the percentage decrease of LDL-C (%) and LDL-C control were analyzed by using logistic regression analyses, multivariate linear regression analyses and the restricted cubic spline.

RESULTS

Over the 6-month follow-up, baseline SUA was independently and positively associated with the percentage decrease of LDL-C (%) and LDL-C control in a dose response fashion. After multivariable adjustment, per SD increment of baseline SUA (120.58 μmol/L) was associated with 3.96% higher percentage decrease of LDL-C(%). The adjusted OR (95% CI) for LDL-C control was 5.62 (2.05, 15.36) when comparing the highest tertile (SUA ≥ 437.0 μmol/L) to the lowest tertile (< 341.7 μmol/L) of baseline SUA.

CONCLUSIONS

Among Chinese patients with first AMI, higher baseline SUA was associated with higher LDL-C deduction percentage (%), and higher rate of LDL-C control in the short-term follow-up, respectively. SUA acquired when AMI occurred was prone to be profitable in predicting the risk stratification of uncontrolled LDL-C and dyslipidemia management.

摘要

背景

关于首次急性心肌梗死(AMI)患者基线血尿酸(SUA)与低密度脂蛋白胆固醇(LDL-C)水平发展关系的数据有限。本研究旨在评估升高的 SUA 是否可预测首次 AMI 中 LDL-C 的发展。

方法

这是一项回顾性的 6 个月队列研究,纳入了 2015 年 1 月至 2019 年 12 月期间在南昌大学第二附属医院心内科首次接受 AMI 治疗并在半年后进行再次评估的 475 例中国住院患者。采用 logistic 回归分析、多元线性回归分析和限制性立方样条分析,评估基线 SUA 与 LDL-C 降低百分比(%)和 LDL-C 控制之间的相关性。

结果

在 6 个月的随访期间,基线 SUA 与 LDL-C 降低百分比(%)和 LDL-C 控制呈剂量反应式独立正相关。经多变量调整后,基线 SUA 每增加 1 个标准差(120.58μmol/L),LDL-C 降低百分比(%)增加 3.96%。与基线 SUA 最低三分位(<341.7μmol/L)相比,最高三分位(SUA≥437.0μmol/L)的 LDL-C 控制的调整比值比(95%CI)为 5.62(2.05,15.36)。

结论

在中国首次 AMI 患者中,较高的基线 SUA 与 LDL-C 降低百分比(%)较高,以及短期随访时 LDL-C 控制率较高分别相关。发生 AMI 时获得的 SUA 可能有助于预测 LDL-C 控制不良的风险分层和血脂异常的管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3e5/8638344/6d9bdb028502/12872_2021_2383_Fig1_HTML.jpg

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