The Journal of Practical Medicine ›› 2024, Vol. 40 ›› Issue (15): 2121-2125.doi: 10.3969/j.issn.1006-5725.2024.15.013
• Clinical Research • Previous Articles Next Articles
Received:
2024-03-01
Online:
2024-08-10
Published:
2024-07-30
Contact:
Zhenqi. SU
E-mail:xyxiewei2007@126.com
CLC Number:
Wei XIE,Zhenqi. SU. Association of lipid variability with adverse cardiovascular events in STEMI patients after emergency percutaneous coronary intervention[J]. The Journal of Practical Medicine, 2024, 40(15): 2121-2125.
Tab.1
Comparison of clinical data between TLF group and control group"
因素 | TLF组 (n = 72) | 对照组 (n = 163) | t/χ2值 | P值 |
---|---|---|---|---|
年龄 | 1.991 | 0.158 | ||
≥ 60岁 | 38(52.78) | 102(62.58) | ||
< 60岁 | 34(47.22) | 61(37.42) | ||
性别 | 1.335 | 0.248 | ||
男 | 55(76.39) | 135(82.82) | ||
女 | 17(23.61) | 28(17.18) | ||
BMI(x ± s,kg/m2) | 24.32 ± 1.69 | 24.15 ± 1.36 | 0.818 | 0.414 |
饮酒史 | 0.321 | 0.571 | ||
有 | 40(55.56) | 97(59.51) | ||
无 | 32(44.44) | 66(40.49) | ||
吸烟史 | 1.348 | 0.246 | ||
有 | 43(59.72) | 84(51.53) | ||
无 | 29(40.28) | 79(48.47) | ||
高血压史 | 1.172 | 0.279 | ||
有 | 52(72.22) | 106(65.03) | ||
无 | 20(27.78) | 57(34.97) | ||
糖尿病史 | 0.521 | 0.471 | ||
有 | 26(36.11) | 67(41.10) | ||
无 | 46(63.89) | 96(58.90) | ||
门球时间(x ± s,min) | 81.24 ± 8.91 | 80.40 ± 8.76 | 0.674 | 0.501 |
心率(x ± s,次/min) | 75.64 ± 3.92 | 76.48 ± 3.74 | 1.564 | 0.119 |
收缩压(x ± s,mmHg) | 121.44 ± 20.57 | 120.35 ± 20.26 | 0.378 | 0.705 |
舒张压(x ± s,mmHg) | 78.16 ± 10.21 | 77.91 ± 10.28 | 0.172 | 0.863 |
Tab.2
Comparison of blood lipid variability between TLF group and control group patients"
项目 | TLF组(n = 72) | 对照组(n = 163) | t值 | P值 |
---|---|---|---|---|
LDL变异性 | ||||
SD | 15.21 ± 2.44 | 13.23 ± 2.19 | 6.166 | < 0.001 |
CV | 0.21 ± 0.04 | 0.18 ± 0.03 | 6.354 | < 0.001 |
VIM | 2.09 ± 0.52 | 1.64 ± 0.37 | 7.546 | < 0.001 |
HDL变异性 | ||||
SD | 4.92 ± 0.78 | 4.56 ± 0.69 | 3.540 | < 0.001 |
CV | 0.24 ± 0.07 | 0.20 ± 0.05 | 4.973 | < 0.001 |
VIM | 1.67 ± 0.44 | 1.42 ± 0.39 | 4.353 | < 0.001 |
LP(a)变异性 | ||||
SD | 6.25 ± 1.08 | 5.63 ± 1.02 | 4.218 | < 0.001 |
CV | 0.19 ± 0.05 | 0.16 ± 0.03 | 5.691 | < 0.001 |
VIM | 1.65 ± 0.49 | 1.41 ± 0.33 | 4.396 | < 0.001 |
Tab.3
Multivariate Cox regression analysis"
变量 | 回归系数 | 标准误 | Wald χ 2 | HR | 95%CI | P值 |
---|---|---|---|---|---|---|
LDL(SD) | 0.914 | 0.404 | 5.118 | 2.494 | 1.547 ~ 3.442 | 0.009 |
LDL(CV) | 0.972 | 0.396 | 6.025 | 2.643 | 2.087 ~ 3.199 | 0.005 |
LDL(VIM) | 1.005 | 0.421 | 5.669 | 2.732 | 2.134 ~ 3.330 | 0.002 |
HDL(SD) | 0.635 | 0.258 | 6.058 | 1.887 | 1.282 ~ 2.492 | 0.023 |
HDL(CV) | 0.815 | 0.334 | 5.954 | 2.259 | 1.197 ~ 3.321 | 0.007 |
HDL(VIM) | 0.787 | 0.375 | 4.404 | 2.197 | 1.429 ~ 2.965 | 0.012 |
LP(a)(SD) | 0.732 | 0.299 | 5.993 | 2.079 | 1.550 ~ 2.608 | 0.018 |
LP(a)(CV) | 0.837 | 0.328 | 6.512 | 2.309 | 1.350 ~ 3.269 | 0.006 |
LP(a)(VIM) | 0.782 | 0.272 | 8.266 | 2.186 | 1.297 ~ 3.075 | 0.012 |
Tab.4
The predictive value of lipid variability in TLF after emergency PCI in STEMI patients"
项目 | AUC | 95%CI | P值 | 截断值 | 特异度(%) | 灵敏度(%) |
---|---|---|---|---|---|---|
LDL(SD) | 0.790 | 0.722 ~ 0.834 | < 0.001 | 14.92 | 80.02 | 76.69 |
LDL(CV) | 0.805 | 0.789 ~ 0.867 | < 0.001 | 0.19 | 83.34 | 82.17 |
LDL(VIM) | 0.833 | 0.797 ~ 0.878 | < 0.001 | 1.83 | 77.61 | 79.88 |
HDL(SD) | 0.766 | 0.715 ~ 0.801 | < 0.001 | 4.79 | 73.49 | 76.25 |
HDL(CV) | 0.795 | 0.741 ~ 0.838 | < 0.001 | 0.22 | 77.93 | 82.74 |
HDL(VIM) | 0.816 | 0.768 ~ 0.850 | < 0.001 | 1.56 | 80.46 | 79.87 |
LP(a)(SD) | 0.773 | 0.723 ~ 0.818 | < 0.001 | 5.90 | 77.21 | 81.93 |
LP(a)(CV) | 0.782 | 0.749 ~ 0.824 | < 0.001 | 0.18 | 80.19 | 79.67 |
LP(a)(VIM) | 0.798 | 0.755 ~ 0.836 | < 0.001 | 1.57 | 78.34 | 76.84 |
1 |
SAITO Y, OYAMA K, TSUJITA K, et al. Treatment strategies of acute myocardial infarction: updates on revascularization, pharmacological therapy, and beyond[J]. J Cardiol, 2023, 81(2):168-178. doi:10.1016/j.jjcc.2022.07.003
doi: 10.1016/j.jjcc.2022.07.003 |
2 |
LI S, GAO X, YANG J, et al. Number of standard modifiable risk factors and mortality in patients with first-presentation ST-segment elevation myocardial infarction: insights from China Acute Myocardial Infarction registry[J]. BMC Med, 2022, 20(1):217. doi:10.1186/s12916-022-02418-w
doi: 10.1186/s12916-022-02418-w |
3 |
SHAH T, KAPADIA S, LANSKY A J, et al. ST-segment elevation myocardial infarction: sex differences in incidence, etiology, treatment, and outcomes [J]. Curr Cardiol Rep, 2022, 24(5):529-540. doi:10.1007/s11886-022-01676-7
doi: 10.1007/s11886-022-01676-7 |
4 |
ELENDU C, AMAECHI D C, ELENDU T C, et al. Comprehensive review of ST-segment elevation myocardial infarction: Understanding pathophysiology, diagnostic strategies, and current treatment approaches[J]. Medicine (Baltimore), 2023, 102(43):e35687. doi:10.1097/md.0000000000035687
doi: 10.1097/md.0000000000035687 |
5 |
TRUESDELL A G, ALASNAG M A, KAUL P, et al. Intravascular imaging during percutaneous coronary intervention: JACC State-of-the-Art Review[J]. J Am Coll Cardiol, 2023, 81(6):590-605. doi:10.1016/j.jacc.2022.11.045
doi: 10.1016/j.jacc.2022.11.045 |
6 |
芮淑红,王晨芳,李云贺,等. 吲哚布芬联合氯吡格雷对急性冠脉综合征患者血管内皮功能、炎性因子、氧化应激的影响[J].实用医学杂志,2023,39(12):1551-1555. doi:10.3969/j.issn.1006-5725.2023.12.016
doi: 10.3969/j.issn.1006-5725.2023.12.016 |
7 |
PROTTY M, SHARP A S P, GALLAGHER S, et al. Defining percutaneous coronary intervention complexity and risk: an analysis of the United Kingdom BCIS database 2006-2016[J]. JACC Cardiovasc Interv, 2022, 15(1):39-49. doi:10.1016/j.jcin.2021.09.039
doi: 10.1016/j.jcin.2021.09.039 |
8 | KHURANA K V, RANJAN A. ST-segment elevation in conditions of non-cardiovascular origin mimicking an acute myocardial infarction: a narrative review[J]. Cureus, 2022, 14(10):e30868. |
9 |
MASROURI S, CHERAGHI L, DERAVI N, et al. Mean versus variability of lipid measurements over 6 years and incident cardiovascular events: More than a decade follow-up[J]. Front Cardiovasc Med, 2022, 9:1065528. doi:10.3389/fcvm.2022.1065528
doi: 10.3389/fcvm.2022.1065528 |
10 |
DONG L, TONG J, FAN S. Association between the serum lipoprotein-associated phospholipase A2 level and acute coronary syndrome[J]. Cardiovasc J Afr, 2023, 34:1-5. doi:10.5830/cvja-2022-056
doi: 10.5830/cvja-2022-056 |
11 |
中华医学会心血管病学分会,中华心血管病杂志编辑委员会.急性ST段抬高型心肌梗死诊断和治疗指南(2019)[J]. 中华心血管病杂志,2019,47(10):766-783. doi:10.3760/cma.j.issn.0253-3758.2019.10.003
doi: 10.3760/cma.j.issn.0253-3758.2019.10.003 |
12 | FRANK M, SANDERS C, BERRY B P. Evaluation and management of ST-segment elevation myocardial infarction in the emergency department[J]. Emerg Med Pract, 2021, 23(1):1-28. |
13 |
王晓敏,徐亚威,毛云,等. 急性ST段抬高型心肌梗死伴射血分数减少型心力衰竭患者左心室逆重构的预测因素[J]. 实用医学杂志,2022,38(10):1236-1239. doi:10.3969/j.issn.1006-5725.2022.10.012
doi: 10.3969/j.issn.1006-5725.2022.10.012 |
14 |
DERMOTT M MC, BING R. Coronary vasospasm and future percutaneous coronary intervention: relax[J]. Heart, 2022, 108(16):1253-1254. doi:10.1136/heartjnl-2022-320974
doi: 10.1136/heartjnl-2022-320974 |
15 |
KOH H P, REDZUAN A MD, MOHD SAFFIAN S, et al. Mortality outcomes and predictors of failed thrombolysis following STEMI thrombolysis in a non-PCI capable tertiary hospital: a 5-year analysis[J]. Intern Emerg Med, 2023, 18(4):1169-1180. doi:10.1007/s11739-023-03202-1
doi: 10.1007/s11739-023-03202-1 |
16 |
TAO S, TANG X, YU L, et al. Prognosis of coronary heart disease after percutaneous coronary intervention: a bibliometric analysis over the period 2004-2022[J]. Eur J Med Res, 2023, 28(1):311. doi:10.1186/s40001-023-01220-5
doi: 10.1186/s40001-023-01220-5 |
17 |
GIBSON C M, AJMI I, VON KOENIG C L, et al. Pressure-controlled intermittent coronary sinus occlusion: a novel approach to improve microvascular flow and reduce infarct size in STEMI[J]. Cardiovasc Revasc Med, 2022, 45:9-14. doi:10.1016/j.carrev.2022.07.007
doi: 10.1016/j.carrev.2022.07.007 |
18 |
MANEMANN S M, BIELINSKI S J, MOSER E D, et al. Variability in lipid levels and risk for cardiovascular disease: an electronic health record-based population cohort study[J]. J Am Heart Assoc, 2023, 12(5):e027639. doi:10.1161/jaha.122.027639
doi: 10.1161/jaha.122.027639 |
19 |
SHEIKH A B, SOBOTKA P A, GARG I, et al. Blood pressure variability in clinical practice: past, present and the future[J]. J Am Heart Assoc, 2023, 12(9):e029297. doi:10.1161/jaha.122.029297
doi: 10.1161/jaha.122.029297 |
20 |
DONG Y, LIU X, ZHAO Y, et al. Attenuating the variability of lipids is beneficial for the hypertension management to reduce the cardiovascular morbidity and mortality in older adults[J]. Front Cardiovasc Med, 2021, 8:692773. doi:10.3389/fcvm.2021.692773
doi: 10.3389/fcvm.2021.692773 |
21 |
NAKANO S, OTAKE H, KAWAMORI H, et al. Association between visit-to-visit variability in low-density lipoprotein cholesterol and plaque rupture that leads to acute coronary syndrome[J]. Circ Rep, 2021, 3(9):540-549. doi:10.1253/circrep.cr-21-0080
doi: 10.1253/circrep.cr-21-0080 |
22 |
BAUTISTA L E, RUEDA-OCHOA O L. Methodological challenges in studies of the role of blood lipids variability in the incidence of cardiovascular disease[J]. Lipids Health Dis, 2021, 20(1):51. doi:10.1186/s12944-021-01477-x
doi: 10.1186/s12944-021-01477-x |
23 | CHAN J S K, SATTI D I, LEE Y H A, et al. High visit-to-visit cholesterol variability predicts heart failure and adverse cardiovascular events: a population-based cohort study[J]. Eur J Prev Cardiol, 2022, 29(14):323-325. |
24 |
NAKAJIMA A, LIBBY P, MITOMO S, et al. Biomarkers associated with coronary high-risk plaques[J]. J Thromb Thrombolysis, 2022, 54(4):647-659. doi:10.1007/s11239-022-02709-2
doi: 10.1007/s11239-022-02709-2 |
25 | WANG X, SHAN D K, DOU G H, et al. Lipoprotein(a) is associated with coronary atheroma progression: analysis from a serial coronary computed tomography angiography study[J]. J Geriatr Cardiol, 2021, 18(12):996-1007. |
26 |
LI S, HOU L, ZHU S, et al. Lipid variability and risk of cardiovascular diseases and all-cause mortality: a systematic review and meta-analysis of cohort studies[J]. Nutrients, 2022, 14(12):2450. doi:10.3390/nu14122450
doi: 10.3390/nu14122450 |
Viewed | ||||||
Full text |
|
|||||
Abstract |
|
|||||