Department of Cardiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Department of Cardiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
In Vivo. 2024 Nov-Dec;38(6):3078-3084. doi: 10.21873/invivo.13792.
BACKGROUND/AIM: Hypertriglyceridemia is a known cardiovascular risk factor. However, the relationship between serum triglyceride (TG) levels and the clinical outcomes in patients with acute myocardial infarction (AMI) is unclear.
We conducted a single-center, retrospective observational study involving 538 consecutive patients with AMI who underwent emergent percutaneous coronary intervention within 12 hours of onset. Patients were categorized into three groups based on their serum TG levels at admission as follows: T1 group (TG <78 mg/dl, n=172), T2 group (78≤TG<141 mg/dl, n=177), and T3 group (141 mg/dl ≤TG, n=176). The primary endpoint was major adverse cardiovascular events (MACEs) defined as a composite of cardiovascular death, non-fatal MI, and non-fatal stroke. The median follow-up period was 2.4 (1.5-4.2) years.
Patients in the T1 group were older, had a higher proportion of females, and had fewer cardiovascular risk factors. However, they also had a higher prevalence of multi-vessel coronary artery disease and severely calcified culprit lesions. The T1 group had a significantly higher rate of MACEs (20.4% in T1, 12.4% in T2 and 8.5% in T3, p<0.05 by Log-rank test, respectively). Multivariate analysis revealed that T1 was an independent predictor of MACEs (hazard ratio=2.19, 95% confidence interval=1.16-4.14, p<0.05).
Although patients with AMI with low TG levels at admission had fewer coronary risk factors, they had more severe calcified culprit lesions and worse clinical outcomes.
背景/目的：高甘油三酯血症是一种已知的心血管危险因素。然而，血清甘油三酯（TG）水平与急性心肌梗死（AMI）患者的临床结局之间的关系尚不清楚。
我们进行了一项单中心、回顾性观察性研究，纳入了 538 例在发病 12 小时内行急诊经皮冠状动脉介入治疗的 AMI 连续患者。根据入院时的血清 TG 水平，将患者分为三组：T1 组（TG<78mg/dl，n=172）、T2 组（78≤TG<141mg/dl，n=177）和 T3 组（TG≥141mg/dl，n=176）。主要终点是主要不良心血管事件（MACEs），定义为心血管死亡、非致死性心肌梗死和非致死性卒中的复合终点。中位随访时间为 2.4（1.5-4.2）年。
T1 组患者年龄较大，女性比例较高，心血管危险因素较少。然而，他们也有更多的多支冠状动脉疾病和严重钙化的罪犯病变。T1 组的 MACEs 发生率明显较高（T1 组为 20.4%，T2 组为 12.4%，T3 组为 8.5%，Log-rank 检验分别为 p<0.05）。多变量分析显示，T1 是 MACEs 的独立预测因子（危险比=2.19，95%置信区间=1.16-4.14，p<0.05）。
尽管入院时 TG 水平较低的 AMI 患者的冠状动脉危险因素较少，但他们有更严重的钙化罪犯病变和更差的临床结局。
