Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Department of Geriatrics, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Front Public Health. 2022 Feb 8;10:804031. doi: 10.3389/fpubh.2022.804031. eCollection 2022.
Exploring the risk factors of prognosis in patients undergoing percutaneous coronary intervention (PCI) is of great importance. Our aim of the study is to investigate the association between variability in total cholesterol (TC) level and major adverse cardiovascular and cerebrovascular events (MACCE) in patients after PCI.
Between April 2004 and December 2009, 909 patients who underwent primary PCI and with at least three TC values were included in the final study. TC variability was calculated using four indices: standard deviation (SD), coefficient of variation (CV), the average successive variability (ASV), variability independent of the mean (VIM). MACCE comprised all-cause mortality, non-fatal myocardial infarction (MI), unplanned revascularization, hospitalization for heart failure, and non-fatal stroke.
There were 394 cases of MACCE during the follow-up period. When the subjects were divided into quartile groups by CV of TC, high CV groups were associated with a higher hazard ratio of MACCE than for lower CV groups. In multivariable adjusted models, TC variability and MACCE remained correlated [HR (95% CI): Q2, 1.17 (0.86-1.58); Q3, 1.38 (1.03-1.85); Q4, 1.63 (1.22-2.17)]. Similar patterns of MACCE were noted by quartiles of SD, ASV, and VIM.
Visit-to-visit TC variability is positively correlated with MACCE in patients after PCI.
探讨经皮冠状动脉介入治疗（PCI）患者预后的危险因素具有重要意义。本研究旨在探讨 PCI 后患者总胆固醇（TC）水平变化与主要不良心脑血管事件（MACCE）的关系。
本研究纳入 2004 年 4 月至 2009 年 12 月期间行直接 PCI 治疗且至少有 3 次 TC 值的 909 例患者。采用标准差（SD）、变异系数（CV）、平均连续变化率（ASV）和均值独立变异（VIM）4 项指标评估 TC 变异性。MACCE 包括全因死亡率、非致死性心肌梗死（MI）、计划外血运重建、心力衰竭住院和非致死性卒中。
随访期间共发生 394 例 MACCE。根据 TC 的 CV 将患者分为四分位组时，CV 较高的组发生 MACCE 的风险比高于 CV 较低的组。在多变量校正模型中，TC 变异性与 MACCE 仍相关[HR（95%CI）：Q2 为 1.17（0.86-1.58）；Q3 为 1.38（1.03-1.85）；Q4 为 1.63（1.22-2.17）]。SD、ASV 和 VIM 的四分位组也观察到了类似的 MACCE 模式。
PCI 后患者 TC 水平的变异性与 MACCE 呈正相关。
