血浆致动脉粥样硬化指数与经皮冠状动脉介入治疗患者重复靶血管血运重建之间的 U 型关系：一项回顾性研究。

A U-shaped relationship between the atherogenic index of plasma and repeated target vessel revascularization in patients undergoing percutaneous coronary intervention: a retrospective study.

机构信息

Department of Cardiology, The Second Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China.

Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, Guangdong, China.

出版信息

Front Endocrinol (Lausanne). 2024 Nov 11;15:1428830. doi: 10.3389/fendo.2024.1428830. eCollection 2024.

DOI:10.3389/fendo.2024.1428830

PMID:39588335

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11586652/

Abstract

BACKGROUND

Atherogenic index of plasma (AIP) has been recognized as a novel and practical marker for the assessment of cardiometabolic risk, but the relevance of AIP as a prognostic biomarker in coronary artery disease (CAD) remains debated. This study investigated the association between AIP and major adverse cardiac and cerebrovascular events (MACCEs) in CAD patients receiving percutaneous coronary intervention (PCI) with drug-eluting stents (DES).

METHODS

A total of 2,250 patients undergoing PCI with DES were included in this retrospective cohort study. The primary endpoint was MACCEs, encompassing acute myocardial infarction, repeat target vessel revascularization (TVR), stroke, and all-cause mortality. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Restricted cubic splines were applied to explore the dose-response associations. And subgroup analysis was conducted to evaluate potential relationship between AIP and MACCEs across different subgroups.

RESULTS

During a medium follow-up of 29.8 (25.6-34.0) months, 106 (4.7%) patients experienced TVR. After adjusting for confounders, AIP (per 1 SD increase) was positively associated with TVR (odds ratio [OR] = 1.26, 95% confidence interval [CI] = 1.01-1.58, = 0.042). In females, there was a significant association (OR = 2.33, 95% CI = 1.40-3.98, = 0.002), but no significant association was observed in males. There was an interaction between AIP and gender ( = 0.017). Restricted cubic spline analysis depicted a U-shaped relationship between AIP and TVR ( = 0.016), with an elevated risk evident from an AIP of 0.20.

CONCLUSION

AIP showed a U-shaped relationship with TVR in PCI patients with DES, particularly pronounced among females. We suggested that the AIP should be used as a plasma marker of key interest for preventing TVR after DES implantation in patients with CAD.

摘要

背景

血浆致动脉粥样硬化指数（AIP）已被认为是评估代谢相关心血管风险的一种新颖且实用的标志物，但 AIP 作为冠心病（CAD）预后生物标志物的相关性仍存在争议。本研究旨在探讨经皮冠状动脉介入治疗（PCI）联合药物洗脱支架（DES）治疗 CAD 患者中 AIP 与主要不良心脑血管事件（MACCE）之间的关系。

方法

本回顾性队列研究共纳入 2250 例行 PCI 联合 DES 治疗的患者。主要终点为 MACCE，包括急性心肌梗死、靶血管血运重建（TVR）、卒中和全因死亡率。采用 logistic 回归模型估计比值比（OR）及其 95%置信区间（CI）。采用受限立方样条探索剂量-反应关系。并进行亚组分析，以评估 AIP 与 MACCE 之间的潜在关系在不同亚组之间的差异。

结果

在中位随访 29.8（25.6-34.0）个月期间，106 例（4.7%）患者发生 TVR。调整混杂因素后，AIP（每增加 1SD）与 TVR 呈正相关（OR=1.26，95%CI=1.01-1.58， =0.042）。在女性中，这种相关性具有统计学意义（OR=2.33，95%CI=1.40-3.98， =0.002），但在男性中无统计学意义。AIP 与性别之间存在交互作用（ = 0.017）。受限立方样条分析显示 AIP 与 TVR 之间呈 U 型关系（ = 0.016），AIP 为 0.20 时风险增加。