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脂蛋白(a)与急性肺栓塞患者 CT 肺动脉造影显示的血栓负荷无关。

Lipoprotein (a) is not associated with thrombus burden derived from CT pulmonary angiography in patients with acute pulmonary embolism.

机构信息

Division of Angiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.

Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria.

出版信息

Sci Rep. 2024 Oct 29;14(1):25962. doi: 10.1038/s41598-024-77669-z.


DOI:10.1038/s41598-024-77669-z
PMID:39472600
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11522666/
Abstract

Lipoprotein (a) [Lp(a)] is suspected to have antifibrinolytic effects, however, its relevance for the severity of venous thromboembolic events remains unclear. We studied the association of Lp(a) levels with thrombus load in pulmonary embolism (PE). 90 patients (40% female, median age 70 [56-79] years) at our tertiary care hospital with a diagnosis of acute PE, available Lp(a) levels and CT pulmonary angiography (CT-PA) performed between April 2017 and December 2019 were included. All CT-PA scans were reanalyzed and thrombus load was determined via Qanadli CT obstruction index (CTOI) and most proximal thrombus location. Median Lp(a) levels were 11.4 [9.3-29.1] mg/dL, median D-dimer levels were 4.6 [2.1-9.8] mg/L, median CTOI was 23 [8-50], central PE was present in 27 (30%) patients. Lp(a) did not correlate with CTOI (r = 0.02, p = 0.922) and was not associated with thrombus location (p = 0.369). CTOI significantly correlated with D-dimer (r = 0.43, p < 0.001) and right to left ventricular diameter ratio (r=-0.49, p = < 0.001). Our findings showed that Lp(a) is not associated with thrombus burden in PE, which suggests that a relevant effect of Lp(a) on the extent of venous thromboembolism is unlikely.

摘要

脂蛋白 (a) [Lp(a)] 被怀疑具有抗纤维蛋白溶解作用,但其与静脉血栓栓塞事件严重程度的相关性尚不清楚。我们研究了 Lp(a) 水平与肺栓塞 (PE) 血栓负荷的关系。我们的三级护理医院收治了 90 名急性 PE 患者(40%为女性,中位年龄 70[56-79]岁),这些患者的 Lp(a) 水平和 2017 年 4 月至 2019 年 12 月期间进行的 CT 肺动脉造影 (CT-PA) 都可用。对所有 CT-PA 扫描进行重新分析,并通过 Qanadli CT 阻塞指数 (CTOI) 和最接近血栓的位置确定血栓负荷。中位 Lp(a) 水平为 11.4[9.3-29.1]mg/dL,中位 D-二聚体水平为 4.6[2.1-9.8]mg/L,中位 CTOI 为 23[8-50],27 例(30%)患者存在中央型 PE。Lp(a) 与 CTOI 无相关性(r=0.02,p=0.922),与血栓位置无相关性(p=0.369)。CTOI 与 D-二聚体显著相关(r=0.43,p<0.001),与右室与左室直径比负相关(r=-0.49,p<0.001)。我们的研究结果表明,Lp(a) 与 PE 中的血栓负荷无关,这表明 Lp(a) 对静脉血栓栓塞程度的影响可能不大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a00/11522666/7f8d793f47b6/41598_2024_77669_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a00/11522666/d104d5654708/41598_2024_77669_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a00/11522666/b60995e81f54/41598_2024_77669_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a00/11522666/7f8d793f47b6/41598_2024_77669_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a00/11522666/d104d5654708/41598_2024_77669_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a00/11522666/b60995e81f54/41598_2024_77669_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a00/11522666/7f8d793f47b6/41598_2024_77669_Fig3_HTML.jpg

相似文献

[1]
Lipoprotein (a) is not associated with thrombus burden derived from CT pulmonary angiography in patients with acute pulmonary embolism.

Sci Rep. 2024-10-29

[2]
Indicators for Hospitalization in Acute Pulmonary Embolism: Uncover the Association Between D-dimer Levels, Thrombus Volume and Radiomics.

Acad Radiol. 2024-6

[3]
Quantitative d-dimer levels and the extent of venous thromboembolism in CT angiography and lower limb ultrasonography.

Vasa. 2007-11

[4]
Usefulness of admission red blood cell distribution width as a predictor of severity of acute pulmonary embolism.

Clin Respir J. 2018-2

[5]
D-Dimer and thrombus burden in acute pulmonary embolism.

Am J Emerg Med. 2018-1-17

[6]
Association between computed tomography obstruction index and mortality in elderly patients with acute pulmonary embolism: A prospective validation study.

PLoS One. 2017-6-8

[7]
Correlation of D-dimer level with the radiological severity indexes of pulmonary embolism on computed tomography pulmonary angiography.

Chin Med J (Engl). 2014

[8]
Relationship of the Novel Scoring System for Lower Extremity Venous Thrombosis with Pulmonary Embolism.

Acad Radiol. 2024-9

[9]
d-dimer is a predictor of clot resolution in patients with pulmonary thromboembolism: A retrospective cohort study.

Clin Respir J. 2020-6

[10]
Overuse of computed tomography pulmonary angiography in the evaluation of patients with suspected pulmonary embolism in the emergency department.

Acad Emerg Med. 2012-11

本文引用的文献

[1]
Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement.

Eur Heart J. 2022-10-14

[2]
Diagnosing Pulmonary Embolism With Computed Tomography Pulmonary Angiography: Diagnostic Accuracy of a Reduced Scan Range.

J Thorac Imaging. 2022-9-1

[3]
Beyond fibrinolysis: The confounding role of Lp(a) in thrombosis.

Atherosclerosis. 2022-5

[4]
Risks of deep vein thrombosis, pulmonary embolism, and bleeding after covid-19: nationwide self-controlled cases series and matched cohort study.

BMJ. 2022-4-6

[5]
Acute Pulmonary Embolism: Prognostic Role of Computed Tomography Pulmonary Angiography (CTPA).

Tomography. 2022-2-14

[6]
Lipoprotein(a) and Pulmonary Embolism Severity-A Retrospective Data Analysis.

Front Cardiovasc Med. 2022-2-7

[7]
Repeat Measures of Lipoprotein(a) Molar Concentration and Cardiovascular Risk.

J Am Coll Cardiol. 2022-2-22

[8]
Angiopoietin-2 correlates with pulmonary embolism severity, right ventricular dysfunction, and intensive care unit admission.

Vasc Med. 2021-10

[9]
How significant is the antifibrinolytic effect of lipoprotein(a) for blood clot lysis?

Thromb Res. 2021-2

[10]
2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS).

Eur Heart J. 2020-1-21

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