Drwila Dominika, Rostoff Pawel, Nessler Jadwiga, Konduracka Ewa
Bratisl Lek Listy. 2022;123(12):872-877. doi: 10.4149/BLL_2022_139.
Coronary artery disease (CAD) remains a leading cause of death in elderly patients. Recently, novel lipoproteins- Atherogenic Index of Plasma (AIP), Atherogenic Coefficient (AC) and Lipoprotein Combine Index (LCI) have been suggested as CAD risk factors; their clinical usefulness, however, remains unknown. The aim of the study was to assess the predictive value of AIP, AC and LCI concerning incidence of major adverse cardiovascular events (MACE) and all-cause mortality in 1-year follow-up.
For the study, 1,083 patients, aged 60 or older, with NSTEMI were enrolled and divided into two groups: young-old and old-old.
MACE occurred in 11.8 % of the patients; LCI showed a borderline significance, but only in univariate analysis. Analysis in groups revealed ambiguous results. None of the examined indices was a predictor of MACE in the young-old group whereas all three of them were significant, but negative predictors in the old-old group. Finally, all-cause mortality at follow-up was 14.9 %. AC predicted 1-year mortality in the whole study population (OR = 1.1 (95% CI: 1-1.2; p = 0.02), but was insignificant in the multivariable model. Additionally, it was an independent predictor in the old-old group, but with borderline significance (OR = 1.14 (95% CI: 1-1.3, p = 0.036).
AIP, AC and LCI should not be used as predictors of MACE and 1-year mortality among elderly patients with NSTEMI (Tab. 5, Ref. 23).
冠状动脉疾病(CAD)仍是老年患者死亡的主要原因。最近,新型脂蛋白——血浆致动脉粥样硬化指数(AIP)、致动脉粥样硬化系数(AC)和脂蛋白综合指数(LCI)被认为是CAD的危险因素;然而,它们的临床实用性尚不清楚。本研究的目的是评估AIP、AC和LCI对1年随访中主要不良心血管事件(MACE)发生率和全因死亡率的预测价值。
本研究纳入了1083例年龄在60岁及以上的非ST段抬高型心肌梗死(NSTEMI)患者,并将其分为两组:年轻老年人组和高龄老年人组。
11.8%的患者发生了MACE;LCI仅在单因素分析中显示出临界显著性。分组分析结果不明确。在年轻老年人组中,所检测的指标均不是MACE的预测因子,而在高龄老年人组中,所有三个指标均具有显著性,但为负性预测因子。最后,随访时的全因死亡率为14.9%。AC在整个研究人群中预测1年死亡率(OR = 1.1(95%CI:1 - 1.2;p = 0.02)),但在多变量模型中不显著。此外,它在高龄老年人组中是一个独立预测因子,但具有临界显著性(OR = 1.14(95%CI:1 - 1.3,p = 0.036))。
AIP、AC和LCI不应作为老年NSTEMI患者MACE和1年死亡率的预测指标(表5,参考文献23)。