Zhang Siyi, Zhou Yue, Wang Jinghui, Fu Qingan, Shen Tianzhou, Pan Guanrui, Luo Renfei, Yang Xinlei, Jiang Long, Hu Hui
Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People's Republic of China.
Department of Clinical Medicine, Queen Mary School of Nanchang University, Nanchang, Jiangxi Province, People's Republic of China.
Int J Gen Med. 2024 May 8;17:2001-2009. doi: 10.2147/IJGM.S449400. eCollection 2024.
Lipoprotein(a) [Lp(a)] is a well-established risk factor for ischaemic stroke (IS). It is unclear whether Lp(a) is associated with IS in patients with atrial fibrillation (AF). The aim of this study is to explore the association between the concentration of Lp(a) and the risk of IS in AF patients, hope to find the potential risk factor for the IS in AF patients.
This study is a retrospective cohort study. The screened AF patients between January 2017 and July 2021 were matched at 1:1 by the propensity score matching (PSM) method in the Second Affiliated Hospital of Nanchang University. Associations between Lp(a) and ischaemic stroke were analysed using logistic regression models, stratified analysis and sensitivity analysis. Statistical analyses were conducted using IBM SPSS software.
The number of enrolled participates is 2258, which contains 1129 non-AF patients and 1129 AF patients. Among IS patients, the median Lp(a) concentration was higher than that of controls (17.03 vs. 15.36 mg/dL, P = 0.032). The Spearman rank-order correlation coefficients revealed significant positive relationships between IS and Lp(a) (P = 0.032). In addition, a significant increase in IS risk was associated with Lp(a) levels >30.00 mg/dL in unadjusted model [OR:1.263, 95% CI(1.046-1.523), P = 0.015], model 1 [OR:1.284, 95% CI(1.062,1.552), P = 0.010], model 2 [OR: 1.297, 95% CI(1.07,1.573). P = 0.008], and model 3 [OR: 1.290, 95% CI (1.064, 1.562). P = 0.009]. The stratified analysis indicated that this correlation was not affected by female sex [1.484 (1.117, 1.972), P = 0.006], age ≤ 60 [1.864 (1.067-3.254), P=0.029], hypertension [1.359 (1.074, 1.721), P = 0.011], or non-coronary heart disease (CHD) [1.388 (1.108, 1.738), P = 0.004].
High levels of Lp(a) were significantly related to IS in AF patients and may be a potential risk factor in the onset of an IS in AF patients.
脂蛋白(a)[Lp(a)]是缺血性卒中(IS)公认的危险因素。目前尚不清楚Lp(a)是否与心房颤动(AF)患者的IS相关。本研究旨在探讨AF患者Lp(a)浓度与IS风险之间的关联，希望找到AF患者发生IS的潜在危险因素。
本研究为回顾性队列研究。2017年1月至2021年7月期间筛选出的AF患者在南昌大学第二附属医院采用倾向评分匹配(PSM)方法进行1:1匹配。采用logistic回归模型、分层分析和敏感性分析分析Lp(a)与缺血性卒中之间的关联。使用IBM SPSS软件进行统计分析。
纳入研究对象2258例，其中非AF患者1129例，AF患者1129例。在IS患者中，Lp(a)浓度中位数高于对照组(17.03 vs. 15.36 mg/dL，P = 0.032)。Spearman等级相关系数显示IS与Lp(a)之间存在显著正相关(P = 0.032)。此外，在未调整模型[OR:1.263，95%CI(1.046 - 1.523)，P = 0.015]、模型1[OR:1.284，95%CI(1.062,1.552)，P = 0.010]、模型2[OR: 1.297，95%CI(1.07,1.573)。P = 0.008]和模型3[OR: 1.290，95%CI (1.064, 1.562)。P = 0.009]中，Lp(a)水平>30.00 mg/dL与IS风险显著增加相关。分层分析表明，这种相关性不受女性[1.484(1.117,1.972)，P = 0.006]、年龄≤60岁[1.864(1.憨67 - 3.254)，P = 0.029]、高血压[1 .359(1.074,1.7憨1)，P = 0.011]或非冠心病(CHD)[1.388(1.108,1.7憨8)，P = 0.004]的影响。
AF患者中高水平的Lp(a)与IS显著相关，可能是AF患者发生IS的潜在危险因素。
