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载脂蛋白 B 与 LDL-C 比值在动脉粥样硬化斑块中的作用及其与心血管事件的关系

Association of LDL-C level with neoatherosclerosis and plaque vulnerability in patients with late restenosis: an optical coherence tomography study.

机构信息

Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China.

Department of Cardiology, the Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai, China.

出版信息

Int J Cardiovasc Imaging. 2023 Dec;39(12):2609-2619. doi: 10.1007/s10554-023-02956-1. Epub 2023 Oct 7.

DOI:10.1007/s10554-023-02956-1
PMID:37804387
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10691981/
Abstract

Neoatherosclerosis (NA) is a significant contributor to late stent failure; however, predictors of late in-stent restenosis (ISR) with NA have not been systematically reported. This study aimed to identify predictors of NA incidence and plaque vulnerability in patients with late ISR and the role of low-density lipoprotein cholesterol (LDL-C) levels in this process. A total of 216 patients with 216 lesions who underwent optical coherence tomography (OCT) before interventional procedure for late drug-eluting stent ISR were enrolled and divided into NA and non-NA groups based on OCT findings. Results showed that higher LDL-C levels were associated with NA, thin-cap fibroatheroma (TCFA), intimal disruption, plaque erosion, and thrombosis. Multivariate regression analysis revealed that the LDL-C level was an independent risk factor for NA and TCFA. The LDL-C levels exhibited a significant predictive value for NA and TCFA, surpassing other factors such as stent age and other lipid types. In conclusion, a high LDL-C level is an independent predictor of NA incidence and plaque vulnerability in patients with late ISR.

摘要

动脉新生内膜形成（NA）是导致晚期支架失败的重要原因，但目前尚未系统报道与 NA 相关的晚期支架内再狭窄（ISR）的预测因素。本研究旨在确定晚期 ISR 患者发生 NA 和易损斑块的预测因素，以及低密度脂蛋白胆固醇（LDL-C）水平在这一过程中的作用。共纳入 216 例因晚期药物洗脱支架 ISR 而行介入治疗前接受光学相干断层扫描（OCT）检查的患者，根据 OCT 结果分为 NA 组和非 NA 组。结果显示，较高的 LDL-C 水平与 NA、薄帽纤维粥样斑块（TCFA）、内膜撕裂、斑块侵蚀和血栓形成有关。多变量回归分析显示，LDL-C 水平是 NA 和 TCFA 的独立危险因素。LDL-C 水平对 NA 和 TCFA 具有显著的预测价值，超过了支架年龄和其他脂质类型等其他因素。总之，高 LDL-C 水平是晚期 ISR 患者发生 NA 和易损斑块的独立预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a08e/10691981/5716ca40aff9/10554_2023_2956_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a08e/10691981/f37c7257967d/10554_2023_2956_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a08e/10691981/6f54ba72a16c/10554_2023_2956_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a08e/10691981/8d12c0e1e425/10554_2023_2956_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a08e/10691981/6d9fe5a22fbd/10554_2023_2956_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a08e/10691981/5716ca40aff9/10554_2023_2956_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a08e/10691981/f37c7257967d/10554_2023_2956_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a08e/10691981/6f54ba72a16c/10554_2023_2956_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a08e/10691981/8d12c0e1e425/10554_2023_2956_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a08e/10691981/6d9fe5a22fbd/10554_2023_2956_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a08e/10691981/5716ca40aff9/10554_2023_2956_Fig5_HTML.jpg

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