Gao Po, Zhang Jing, Fan Xizhen
Department of Cardiovascular Medicine, Hefei Second People's Hospital, Hefei Hospital Affiliated to Anhui Medical University, 230000 Hefei, Anhui, China.
Department of Cardiovascular Medicine, The First Affiliated Hospital of University of Science and Technology of China, Anhui Provincial Hospital, 230000 Hefei, Anhui, China.
Rev Cardiovasc Med. 2022 Dec 9;23(12):398. doi: 10.31083/j.rcm2312398. eCollection 2022 Dec.
In this study, we investigated whether the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR) is associated with the development of acute ST-segment elevation myocardial infarction (STEMI).
889 STEMI patients who had not previously received lipid-lowering therapy were selected as the test group and 120 patients with less than 50% coronary stenosis were selected as the control group. All patients completed the related blood tests the morning after admission, and Gensini scores were based on coronary angiography results. The differences were compared using a -test, rank sum test, chi-square test and logistic regression analysis. Linear regression analysis was used to study the correlation between variables. Receiver Operating Characteristic (ROC) curves were used to validate the predictive value of NHHR for STEMI.
NHHR was shown to be a significant independent risk factor for STEMI according to binary logistic regression analysis (OR = 0.163, 95% CI: 0.065-0.411, 0.05). There were shown to be differences in the NHHR depending on the gender of the STEMI patients (z = -1.663, 0.1). Linear regression analysis revealed a stronger correlation between NHHR and Gensini score (r = 0.394, 0.05) in the test group. Finally, we demonstrated that NHHR has a good predictive effect on STEMI, using an ROC curve (Area Under Curve (AUC): 0.818, 95% CI: 0.777-0.859, 0.05).
NHHR is a good predictor of coronary artery disease severity in STEMI patients and an important independent risk factor for STEMI, especially for patients who have not received lipid-lowering treatment in the past, and male STEMI patients need more stringent lipids management than female STEMI patients.
在本研究中，我们调查了非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇的比值（NHHR）是否与急性ST段抬高型心肌梗死（STEMI）的发生有关。
选取889例既往未接受过降脂治疗的STEMI患者作为试验组，选取120例冠状动脉狭窄程度小于50%的患者作为对照组。所有患者在入院次日早晨完成相关血液检查，Gensini评分基于冠状动脉造影结果。采用t检验、秩和检验、卡方检验和逻辑回归分析比较差异。采用线性回归分析研究变量之间的相关性。采用受试者工作特征（ROC）曲线验证NHHR对STEMI的预测价值。
二元逻辑回归分析显示，NHHR是STEMI的一个显著独立危险因素（OR = 0.163，95%CI：0.065 - 0.411，P < 0.05）。根据STEMI患者的性别，NHHR存在差异（z = -1.663，P < 0.1）。线性回归分析显示，试验组中NHHR与Gensini评分之间的相关性更强（r = 0.394，P < 0.05）。最后，我们通过ROC曲线证明NHHR对STEMI具有良好的预测作用（曲线下面积（AUC）：0.818，95%CI：0.777 - 0.859，P < 0.05）。
NHHR是STEMI患者冠状动脉疾病严重程度的良好预测指标，也是STEMI的重要独立危险因素，尤其是对于既往未接受过降脂治疗的患者，男性STEMI患者比女性STEMI患者需要更严格的血脂管理。
