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载脂蛋白指数与糖化血清白蛋白联合预测经皮冠状动脉介入治疗后急性冠脉综合征绝经后患者心血管事件的发生风险。

The combined predictive power of the atherogenic index of plasma and serum glycated albumin for cardiovascular events in postmenopausal patients with acute coronary syndrome after percutaneous coronary intervention.

机构信息

Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China.

Department of Medicine, Division of Cardiology, University of California, Los Angeles, CA, USA.

出版信息

Lipids Health Dis. 2024 Oct 30;23(1):352. doi: 10.1186/s12944-024-02335-2.

Abstract

BACKGROUND

Glycated Albumin (GA) and atherogenic index of plasma (AIP) are two important biomarkers that respectively reflect lipid and glucose levels. Previous research has revealed their roles in cardiovascular diseases (CVD) and diabetes. However, their combined predictive ability in forecasting cardiovascular events (CVE) after percutaneous coronary intervention (PCI) among postmenopausal acute coronary syndrome (ACS) patients remains insufficiently studied.

METHODS

Based on the levels of AIP (AIP-L and AIP-H) and GA (GA-L and GA-H), four groups were used to categorize the patients. The CVE assessed included cardiac death, nonfatal myocardial infarction (MI) and nonfatal stroke. To evaluate the relationship between AIP, GA, and CVE, multivariate Cox regression analyses were performed.

RESULTS

98 patients (7.5%) experienced CVE during follow-up. AIP and GA were revealed as strong independent predictors of CVE through multivariate analysis (AIP: HR 3.324, 95%CI 1.732-6.365, P = 0.004; GA: HR 1.098, 95% CI 1.023-1.177, P = 0.009). In comparison to those in the initial group (AIP-L and GA-L), the fourth group (AIP-H and GA-H) of patients exhibited the greatest CVE risk (HR 2.929, 95% CI 1.206-5.117, P = 0.018). Derived from the model of baseline risk, the combination of AIP + GA significantly enhanced the AUC, meanwhile combining AIP and GA levels maximized prognostic accuracy in the baseline risk model.

CONCLUSIONS

This study found that the combined measurement of AIP and GA significantly enhanced the predictive capability for CVE following PCI in postmenopausal ACS patients. By integrating these two biomarkers, it became possible to more accurately identify high-risk individuals and provided clinicians with new predictive tools for postmenopausal ACS patients in risk assessment and management.

摘要

背景

糖化白蛋白(GA)和血浆致动脉粥样硬化指数(AIP)是两种分别反映血脂和血糖水平的重要生物标志物。先前的研究揭示了它们在心血管疾病(CVD)和糖尿病中的作用。然而,关于它们在绝经后急性冠状动脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)后预测心血管事件(CVE)的综合预测能力,研究仍不够充分。

方法

根据 AIP(AIP-L 和 AIP-H)和 GA(GA-L 和 GA-H)的水平,将患者分为四组。评估的 CVE 包括心脏死亡、非致死性心肌梗死(MI)和非致死性卒中。为了评估 AIP、GA 与 CVE 之间的关系,进行了多变量 Cox 回归分析。

结果

98 例患者(7.5%)在随访期间发生了 CVE。多变量分析显示,AIP 和 GA 是 CVE 的独立强预测因子(AIP:HR 3.324,95%CI 1.732-6.365,P=0.004;GA:HR 1.098,95%CI 1.023-1.177,P=0.009)。与初始组(AIP-L 和 GA-L)相比,第四组(AIP-H 和 GA-H)患者的 CVE 风险最高(HR 2.929,95%CI 1.206-5.117,P=0.018)。从基线风险模型得出,AIP+GA 的联合显著提高了 AUC,同时结合 AIP 和 GA 水平使基线风险模型中的预测准确性最大化。

结论

本研究发现,AIP 和 GA 的联合测量显著提高了绝经后 ACS 患者 PCI 后 CVE 的预测能力。通过整合这两个生物标志物,可以更准确地识别高危个体,并为绝经后 ACS 患者的风险评估和管理提供新的预测工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fe6/11523790/effd38bc0b33/12944_2024_2335_Fig1_HTML.jpg

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