Department of Cardiology, Dongguan People's Hospital, The First School of Clinical Medicine, Southern Medical University, Dongguan, 523059, Guangdong, People's Republic of China.
Department of Cardiology, Shenhe People's Hospital, The Fifth Affiliated Hospital of Jinan University, Heyuan, 517000, Guangdong, People's Republic of China.
Eur J Med Res. 2024 Aug 17;29(1):421. doi: 10.1186/s40001-024-01957-7.
Serum lipoprotein(a) [Lp(a)] is a risk factor of cardiovascular diseases. However, the relationship between the serum Lp(a) and clinical outcomes has been seldom studied in Chinese hospitalized patients with cardiovascular diseases.
We retrospectively collected the clinical data of hospitalized patients with cardiovascular diseases in the Cardiovascular Department of Dongguan People's Hospital from 2016 to 2021 through the electronic case system. Patients were divided into 4 groups based on Lp(a) quartiles: Quartile1 (≤ 80.00 mg/L), Quartile 2 (80.01 ~ 160.90 mg/L), Quartile 3 (160.91 ~ 336.41 mg/L), Quartile 4 (> 336.41 mg/L). Cox proportional hazard regression models were constructed to examine the relationship between Lp(a) and cardiovascular events.
A total of 8382 patients were included in this study. After an average follow-up of 619 (320 to 1061) days, 1361 (16.2%) patients developed major adverse cardiovascular events, and 125 (1.5%) all-cause death were collected. The incidence of MACEs was 7.65, 8.24, 9.73 and 10.75 per 100 person-years in each Lp(a) quartile, respectively; the all-cause mortality was 0.48, 0.69, 0.64 and 1.18 per 100 person-years in each Lp(a) quartile, respectively. The multivariate Cox regression analysis suggested that high Lp(a) level was an independent risk factor for MACEs (HR: 1.189, [95% CI: 1.045 to 1.353], P = 0.030) and all-cause death (HR: 1.573, [95% CI: 1.009 to 2.452], P = 0.046).
In addition to traditional lipid indicators, higher Lp(a) exhibited higher risks of adverse cardiovascular events and death, indicated worse prognosis. Lp(a) may be a new target for the prevention of atherosclerotic diseases.
血清脂蛋白(a)[Lp(a)]是心血管疾病的危险因素。然而,在中国住院的心血管疾病患者中,血清 Lp(a)与临床结局的关系很少被研究。
我们通过电子病历系统回顾性收集了 2016 年至 2021 年期间在东莞人民医院心血管科住院的心血管疾病患者的临床资料。患者根据 Lp(a)四分位间距分为 4 组:第 1 四分位间距(≤80.00mg/L)、第 2 四分位间距(80.01160.90mg/L)、第 3 四分位间距(160.91336.41mg/L)、第 4 四分位间距(>336.41mg/L)。构建 Cox 比例风险回归模型来检验 Lp(a)与心血管事件的关系。
本研究共纳入 8382 例患者。平均随访 619(320 至 1061)天后,1361 例(16.2%)患者发生主要不良心血管事件,125 例(1.5%)患者发生全因死亡。Lp(a)每四分位间距的 MACEs 发生率分别为 7.65、8.24、9.73 和 10.75/100 人年,全因死亡率分别为 0.48、0.69、0.64 和 1.18/100 人年。多变量 Cox 回归分析表明,高 Lp(a)水平是 MACEs(HR:1.189,[95%CI:1.045 至 1.353],P=0.030)和全因死亡(HR:1.573,[95%CI:1.009 至 2.452],P=0.046)的独立危险因素。
除了传统的脂质指标外,较高的 Lp(a)水平显示出更高的不良心血管事件和死亡风险,提示预后更差。Lp(a)可能是动脉粥样硬化疾病预防的新靶点。