远程心脏康复治疗并进行长期随访可降低 GlycA 并改善脂蛋白颗粒谱：一项随机对照试验。

Cardiac telerehabilitation with long-term follow-up reduces GlycA and improves lipoprotein particle profile: A randomised controlled trial.

机构信息

Department of Cardiology, Hospital Arnau de Vilanova, Calle San Clemente 12, 46015 Valencia, Spain.

Department of Clinical Laboratory, Hospital Arnau de Vilanova, Valencia, Spain.

出版信息

Int J Cardiol. 2022 Dec 15;369:60-64. doi: 10.1016/j.ijcard.2022.08.017. Epub 2022 Aug 6.

DOI:10.1016/j.ijcard.2022.08.017

PMID:35944773

Abstract

BACKGROUND

A 10-month strategy of cardiac telerehabilitation (CTR) improved outcomes over a standard centre-based cardiac rehabilitation (CBCR), as recently published. We hypothesised that prolonged telerehabilitation could also improve proinflammatory status and lipoprotein particle composition.

METHODS

A randomised controlled trial compared a prolonged CTR program with CBCR in post-ACS patients. Patient's age was 18-72 years with low-risk criteria. Blood samples were drawn at baseline, at 4- and 10-months follow-up. Advanced lipoprotein characterization was performed using the NMR-based Liposcale test. Signals from glycoproteins (GlycA and GlycB) were also assessed.

RESULTS

The final analysis included 31 patients in the CTR group and 25 patients in the CBCR group. GlycA decreased in the CTR group (p = 0,007). LDL particle number (LDL-P) increase in both groups, but it was at the expense of small-sized LDL in the CBCR group (p = 0.012). Triglycerides in intermediate-density lipoprotein (IDL-TG) increased only in the CBCR group (p = 0.043). The triglyceride-to-HDL (TG/HDL) ratio decreased only in the CTR group (p = 0.006). The TG/HDL ratio was correlated with GlycA (Spearman's correlation coefficient: 0.558, p < 0.001) but not with CRP (p = 0.101).

CONCLUSIONS

Our results showed that a 10-month CTR program reduced GlycA levels, the TG/HDL ratio and avoided unfavourable long-term changes in lipoprotein particle composition. Registration at http://ClinicalTrials.gov. NCT number: 04942977.

摘要

背景

最近发表的一项研究表明，为期 10 个月的心脏远程康复（CTR）策略比标准的中心心脏康复（CBCR）更能改善预后。我们假设，延长远程康复治疗也可以改善促炎状态和脂蛋白颗粒组成。

方法

一项随机对照试验比较了 ACS 后患者的延长远程康复治疗与 CBCR。患者年龄为 18-72 岁，符合低危标准。在基线、4 个月和 10 个月随访时采集血液样本。使用基于 NMR 的 Liposcale 测试进行先进的脂蛋白特征分析。还评估了糖蛋白（GlycA 和 GlycB）的信号。

结果

最终分析包括 CTR 组的 31 名患者和 CBCR 组的 25 名患者。CTR 组的 GlycA 降低（p=0.007）。两组 LDL 颗粒数（LDL-P）均增加，但 CBCR 组的小 LDL 颗粒减少（p=0.012）。只有 CBCR 组的中间密度脂蛋白（IDL-TG）中的甘油三酯增加（p=0.043）。只有 CTR 组的甘油三酯/高密度脂蛋白（TG/HDL）比值降低（p=0.006）。TG/HDL 比值与 GlycA 呈相关性（Spearman 相关系数：0.558，p<0.001），但与 CRP 无相关性（p=0.101）。