Gao Hui, Shen Aidong, Chen Hui, Li Hongwei
Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Department of Internal Medical, Medical Health Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Front Cardiovasc Med. 2021 Oct 11;8:750670. doi: 10.3389/fcvm.2021.750670. eCollection 2021.
The association between obesity, non-HDL cholesterol, and clinical outcomes in subjects with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) is incompletely understood. The aim of this investigation was to explore the association between body mass index (BMI), non-high density lipoprotein (non-HDL) cholesterol, and long-term follow-up prognosis. This present study used data obtained by the Cardiovascular Center of Beijing Friendship Hospital Database Bank. We identified 3,780 consecutive AMI populations aged 25-93 years from 2013 to 2020. Participants were categorized as normal weight (18.5 ≤ BMI <22.9 kg/m), overweight (23.0 ≤ BMI <24.9 kg/m), obese class I (25.0 ≤ BMI <29.9 kg/m), and obese class II (BMI ≥ 30.0 kg/m). The endpoint of interest was cardiovascular (CV) death, all-cause death, myocardial infarction (MI), stroke, unplanned revascularization, and cardiac hospitalization. Participants with higher BMI were younger and more likely to be males compared with lower BMI groups. Elevated non-HDL cholesterol was present in 8.7, 11.0, 24.3, and 5.9% of the normal, overweight, obese class I, and obese class II groups, respectively. After multivariate adjustment, compared to normal-weight participants with decreased non-HDL cholesterol (reference group), obese participants with and without elevated non-HDL cholesterol had a lower risk of mortality (with obese class I and elevated non-HDL cholesterol: hazard ratio [HR] 0.44, 95% confidence interval [CI] 0.28-0.67; with obese class I and decreased non-HDL cholesterol: HR, 0.68, 95% CI, 0.47-0.98; with obese class II and elevated non-HDL cholesterol: HR, 0.42, 95% CI, 0.20-0.87; with obese class II and decreased non-HDL cholesterol: HR, 0.35, 95% CI, 0.16-0.72). In AMI participants performing with PCI, obesity had a better long-term prognosis which probably unaffected by the level of non-HDL cholesterol.
肥胖、非高密度脂蛋白胆固醇与接受经皮冠状动脉介入治疗（PCI）的急性心肌梗死（AMI）患者临床结局之间的关联尚未完全明确。本研究旨在探讨体重指数（BMI）、非高密度脂蛋白（non-HDL）胆固醇与长期随访预后之间的关联。本研究使用了北京友谊医院心血管中心数据库的数据。我们纳入了2013年至2020年间连续入选的3780例年龄在25至93岁之间的AMI患者。参与者被分为正常体重（18.5≤BMI<22.9kg/m）、超重（23.0≤BMI<24.9kg/m）、I类肥胖（25.0≤BMI<29.9kg/m）和II类肥胖（BMI≥30.0kg/m）。感兴趣的终点是心血管（CV）死亡、全因死亡、心肌梗死（MI）、中风、非计划血管重建和心脏住院。与BMI较低的组相比，BMI较高的参与者更年轻，且男性比例更高。正常、超重、I类肥胖和II类肥胖组中，非HDL胆固醇升高的比例分别为8.7%、11.0%、24.3%和5.9%。多因素调整后，与非HDL胆固醇降低的正常体重参与者（参照组）相比，非HDL胆固醇升高和未升高的肥胖参与者死亡风险较低（I类肥胖且非HDL胆固醇升高：风险比[HR]0.44，95%置信区间[CI]0.28-0.67；I类肥胖且非HDL胆固醇降低：HR 0.68，95%CI 0.47-0.98；II类肥胖且非HDL胆固醇升高：HR 0.42，95%CI 0.20-0.87；II类肥胖且非HDL胆固醇降低：HR 0.35，95%CI 0.16-0.72）。在接受PCI的AMI参与者中，肥胖具有较好的长期预后，这可能不受非HDL胆固醇水平的影响。
