Department of Nursing, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, 350001, Fujian, China.
Department of Cardiac Surgery, Fujian Medical University Union Hospital, No. 29 XinquanRoad, Fuzhou, 350001, Fujian, China.
BMC Cardiovasc Disord. 2022 Aug 1;22(1):346. doi: 10.1186/s12872-022-02793-5.
In recent years, abnormalities in serum lipids and lipoproteins have been shown to be associated with cardiovascular disease risk. However, their prognostic value for acute type A aortic dissection is unclear. This study analyzed the correlation between triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio and in-hospital mortality in patients with AAAD, and aimed to investigate the clinical significance of preoperative blood lipids and lipoproteins on the prognosis of acute type A aortic dissection.
A total of 361 patients who underwent type A aortic dissection surgery in Fujian Cardiac Medical Center from June 2018 to March 2020 were retrospectively collected. According to the baseline TG/HDL-C ratio, the patients were divided into 3 groups according to the tertile method, the low TG/HDL-C ratio T1 group (< 1.18) and the middle TG/HDL-C ratio T2 group (1.18-1.70). T3 group with high TG/HDL-C ratio (> 1.70). Kaplan-Meier was used for survival analysis, and Cox proportional hazards regression model was used to analyze the factors affecting the prognosis of patients. The receiver operating characteristic (ROC) curve was used for the diagnostic efficacy.
Among the 361 patients in this study, the mean age was 52.4 ± 11.3 years, 73 (20.2%) were female, and 82 (22.7%) died in hospital. Kaplan-Meier curve showed that with the increase of TG/HDL-C ratio, the risk of in-hospital death gradually increased (P < 0.001). Multivariate Cox regression analysis showed that age (HR = 1.031), body mass index (HR = 1.052), hypertension (HR = 3.491), white blood cells (HR = 1.073), TG/HDL-C ratio (HR = 1.604), MODS (HR = 1.652) was positively correlated with in-hospital mortality (P < 0.05). After adjusting for age, sex, and other risk factors, a significant association was found between the TG/HDL-C ratio and in-hospital mortality for acute type A aortic dissection (HR = 1.472, 95% CI, 1.354-3.451, P = 0.019).
Patients with type A aortic dissection have obvious abnormal blood lipid metabolism, and serum TG/HDL-C levels are positively correlated with in-hospital mortality in patients with AAAD.
近年来，血清脂质和脂蛋白异常与心血管疾病风险相关。然而，其对急性 A 型主动脉夹层的预后价值尚不清楚。本研究分析了甘油三酯/高密度脂蛋白胆固醇（TG/HDL-C）比值与急性 A 型主动脉夹层患者住院死亡率的相关性，并旨在探讨术前血脂和脂蛋白对急性 A 型主动脉夹层预后的临床意义。
回顾性收集 2018 年 6 月至 2020 年 3 月在福建心血管病医院接受 A 型主动脉夹层手术的 361 例患者的临床资料。根据基线 TG/HDL-C 比值，采用三分位数法将患者分为 3 组，低 TG/HDL-C 比值 T1 组（<1.18）、中 TG/HDL-C 比值 T2 组（1.18-1.70）和高 TG/HDL-C 比值 T3 组（>1.70）。采用 Kaplan-Meier 法进行生存分析，采用 Cox 比例风险回归模型分析影响患者预后的因素。采用受试者工作特征（ROC）曲线评估诊断效能。
本研究 361 例患者的平均年龄为 52.4±11.3 岁，73 例（20.2%）为女性，82 例（22.7%）住院期间死亡。Kaplan-Meier 曲线显示，随着 TG/HDL-C 比值的升高，住院死亡风险逐渐增加（P<0.001）。多因素 Cox 回归分析显示，年龄（HR=1.031）、体重指数（HR=1.052）、高血压（HR=3.491）、白细胞（HR=1.073）、TG/HDL-C 比值（HR=1.604）、MODS（HR=1.652）与住院死亡率呈正相关（P<0.05）。调整年龄、性别等危险因素后，TG/HDL-C 比值与急性 A 型主动脉夹层住院死亡率仍呈显著相关（HR=1.472，95%CI，1.354-3.451，P=0.019）。
急性 A 型主动脉夹层患者存在明显的血脂代谢异常，血清 TG/HDL-C 水平与 AAAD 患者住院死亡率呈正相关。
