[1]叶滔 童琳 崔彩艳 成联超 童兰 蔡琳.残余胆固醇对急性冠脉综合征合并/不合并糖尿病患者远期预后的影响[J].心血管病学进展,2024,(8):762.[doi:10.16806/j.cnki.issn.1004-3934.2024.08.019]
　YE Tao,TONG Lin,CUI Caiyan,et al.Effect of Residual Cholesterol on Long-Term Prognosis in Patients with Acute Coronary Syndrome with or without Diabetes Mellitus[J].Advances in Cardiovascular Diseases,2024,(8):762.[doi:10.16806/j.cnki.issn.1004-3934.2024.08.019]
点击复制

残余胆固醇对急性冠脉综合征合并/不合并糖尿病患者远期预后的影响()
分享到：

《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2024年8期
页码:
762
栏目:
论著
出版日期:
2024-08-25

文章信息/Info

Title:
Effect of Residual Cholesterol on Long-Term Prognosis in Patients with Acute Coronary Syndrome with or without Diabetes Mellitus
作者:
叶滔 童琳 崔彩艳 成联超 童兰 蔡琳
?西南交通大学附属医院 成都市第三人民医院心内科 成都市心血管病研究所,四川 成都 610031)
Author(s):
YE Tao; TONG Lin; CUI Caiyan; CHENG Lianchao; TONG Lan; CAI Lin
(Department of Cardiology,The Affiliated Hospital of Southwest Jiaotong University,The Third People’s Hospital of Chengdu,Cardiovascular Disease Research Institute of Chengdu,Chengdu 610031,Sichuan,China)
关键词:
残余胆固醇; 急性冠脉综合征; 糖尿病; 远期预后
Keywords:
Residual cholesterol; Acute coronary syndrome; Diabetes mellitus; Long-term prognosis
DOI:
10.16806/j.cnki.issn.1004-3934.2024.08.019
摘要:
目的 探究残余胆固醇对急性冠脉综合征（ACS）合并或不合并糖尿病患者远期预后的影响。方法 纳入2017年1月—2019年6月于成都11家医院就诊的ACS患者，根据是否合并糖尿病分为非糖尿病组和糖尿病组。再根据残余胆固醇水平（界值0.8 mmol/L）分为残余胆固醇＜0.8 mmol/L和残余胆固醇≥0.8 mmol/L两个亚组。进行随访，观察其主要不良心脑血管事件（MACCE），包括全因死亡、非致死性心肌梗死、非致死性脑卒中和再次血运重建事件的发生率。分别在非糖尿病和糖尿病患者中，比较残余胆固醇＜0.8 mmol/L和残余胆固醇≥0.8 mmol/L两组在随访期间MACCE发生率。结果 本研究纳入ACS患者1 568例：非糖尿病患者1 162例，其中残余胆固醇＜0.8 mmol/L组954例，残余胆固醇≥0.8 mmol/L组208例；糖尿病患者406例，其中残余胆固醇＜0.8 mmol/L组311例，残余胆固醇≥0.8 mmol/L组95例。中位随访时间为14月（8月，21月）。多因素Cox回归分析显示：非糖尿病患者中，残余胆固醇≥0.8 mmol/L是ACS患者MACCE发生的独立预测因子（HR=1.786，95% CI 1.031～3.094，P=0.039）；在糖尿病患者中，残余胆固醇≥0.8 mmol/L不是ACS患者MACCE发生的独立预测因子（HR=0.962，95% CI 0.486～1.904，P=0.912）。结论 残余胆固醇是ACS不合并糖尿病患者远期不良预后的独立预测因子，并不是ACS合并糖尿病患者远期不良预后的独立预测因子。
Abstract:
Objective To investigate the impact of residual cholesterol on the long-term prognosis of patients with acute coronary syndrome (ACS). Methods ACS patients treated at 11 hospitals in Chengdu from January 2017 to June 2019 were included in the study. Patients were divided into non-diabetic group and diabetic group based on whether they had diabetes mellitus. Subquently they were devided into residual cholesterol <0.8 mmol/L and residual cholesterol≥0.8 mmol/L subgroups based on residual cholesterol levels (threshold 0.8 mmol/L). The study endpoints were major adverse cardiovascular and cerebrovascular events (MACCE),including all-cause death,non-fatal myocardial infarction,non-fatal stroke,and revascularization. The incidence of MACCE in the residual cholesterol <0.8 mmol/L group and residual cholesterol≥0.8 mmol/L group were compared. Results Our study included 1 568 ACS patients,of whom 1 162 were non-diabetic patients. Among them,954 were in the residual cholesterol <0.8 mmol/L group,and 208 were in the residual cholesterol≥0.8 mmol/L group. There were 406 diabetic patients,with 311 in the residual cholesterol <0.8 mmol/L group and 95 in the residual cholesterol ≥0.8 mmol/L group. The median follow-up time was 14 months (8,21 months). In non-diabetic patients,residual cholesterol≥0.8 mmol/L was an independent predictor of MACCE in ACS patients (HR=1.786，95% CI 1.031～3.094，P=0.039). However,in diabetic patients,residual cholesterol≥0.8 mmol/L was not an independent predictor of MACCE in ACS patients (HR=0.962，95% CI 0.486～1.904，P=0.912). Conclusion High level residual cholesterol is an independent predictor of long-term poor prognosis in ACS patients without diabetes mellitus,but not in ACS patients with diabetes m ellitus

参考文献/References:

[1].国家卫生计生委合理用药专家委员会,中国药师协会. 冠心病合理用药指南(第2版)[J]. 中国医学前沿杂志(电子版),2018,10(6): 1-130.
[2].成联超,陈应忠,叶滔,等. 区域协同救治体系在ST段抬高型心肌梗死患者行转运急诊经皮冠状动脉介入治疗中的作用[J]. 实用心脑肺血管病杂志,2020,28(3):88-92.
[3].Cui CY,Ye T,Cheng LC,et al. Lipoprotein a combined with fibrinogen as an independent predictor of long-term prognosis in patients with acute coronary syndrome:a multi-center retrospective study[J]. J Cardiovasc Dev Dis,2022,9(10):322.
[4].Ganda OP. Triglyceride-rich lipoproteins,remnant-cholesterol,and atherosclerotic cardiovascular disease[J]. Curr Opin Lipidol,2023,34(3):105-113.
[5].Heo JH,Jo SH. Triglyceride-rich lipoproteins and remnant cholesterol in cardiovascular disease[J]. J Korean Med Sci,2023,38(38):e295.
[6].Fujihara Y,Nakamura T,Horikoshi T,et al. Remnant lipoproteins are residual risk factor for future cardiovascular events in patients with stable coronary artery disease and on-statin low-density lipoprotein cholesterol levels <70 mg/dL[J]. Circ J,2019,83(6):1302-1308.
[7].Yang J,Wang Y,Xi Z,et al. Remnant-like particle cholesterol and the risk of major adverse cardiovascular events:a systematic review and meta-analysis[J]. J Cardiovasc Dev Dis, 2022,9(12):452.
[8].Martin SS,Faridi KF,Joshi PH,et al. Remnant lipoprotein cholesterol and mortality after acute myocardial infarction:further evidence for a hypercholesterolemia paradox from the TRIUMPH registry[J]. Clin Cardiol,2015,38(11):660-667.
[9].Langsted A,Madsen CM,Nordestgaard BG. Contribution of remnant cholesterol to cardiovascular risk[J]. J Intern Med,2020,288(1):116-127.
[10].Wang QC,Wang ZY. Comparative analysis of neutrophil-to-lymphocyte ratio and remnant cholesterol in predicting cardiovascular events and mortality in general adult population[J]. Sci Rep,2023,13(1):22362.
[11].Casta?er O,Pintó X,Subirana I,et al. Remnant cholesterol,not LDL cholesterol,is associated with incident cardiovascular disease[J]. J Am Coll Cardiol,2020,76(23):2712-2724.
[12].Qin Z,Zhou K,Li YP,et al. Remnant lipoproteins play an important role of in-stent restenosis in type 2 diabetes undergoing percutaneous coronary intervention:a single-centre observational cohort study[J]. Cardiovasc Diabetol,2019,18(1):11.
[13].Huh JH,Han KD,Cho YK,et al. Remnant cholesterol and the risk of cardiovascular disease in type 2 diabetes:a nationwide longitudinal cohort study[J]. Cardiovasc Diabetol,2022,21(1):228.
[14].Zhao Q,Zhang TY,Cheng YJ,et al. Prognostic impact of estimated remnant-like particle cholesterol in patients with differing glycometabolic status:an observational cohort study from China[J]. Lipids Health Dis,2020,19(1):179.
[15].Borén J,Chapman MJ,Krauss RM,et al. Low-density lipoproteins cause atherosclerotic cardiovascular disease:pathophysiological,genetic,and therapeutic insights:a consensus statement from the European Atherosclerosis Society Consensus Panel[J]. Eur Heart J,2020,41(24):2313-2330.
[16].Baratta F,Cocomello N,Coronati M,et al. Cholesterol remnants,triglyceride-rich lipoproteins and cardiovascular risk[J]. Int J Mol Sci,2023,24(5):4268.
[17].Schwartz EA,Reaven PD. Lipolysis of triglyceride-rich lipoproteins,vascular inflammation,and atherosclerosis[J]. Biochim Biophys Acta,2012,1821(5):858-866.
[18].Bernelot Moens SJ,Verweij SL,Schnitzler JG,et al. Remnant cholesterol elicits arterial wall inflammation and a multilevel cellular immune response in humans[J]. Arterioscler Thromb Vasc Biol,2017,37(5):969-975.
[19].中国心血管健康与疾病报告编写组. 《中国心血管健康与疾病报告2022》概要[J]. 中国介入心脏病学杂志,2023,31(7):485-508.

相似文献/References:

[1]李润土,何泉.光学相干断层成像在急性冠脉综合征介入治疗中的应用[J].心血管病学进展,2019,(6):856.[doi:10.16806/j.cnki.issn.1004-3934.2019.06.005]
　LI Runtu,HE Quan.Application of Optical Coherent Tomography in Interventional Treatment of Acute Coronary Syndrome[J].Advances in Cardiovascular Diseases,2019,(8):856.[doi:10.16806/j.cnki.issn.1004-3934.2019.06.005]
[2]郑晓雪 季福绥.急性冠脉综合征患者发生急性肾损伤的临床进展[J].心血管病学进展,2019,(5):713.[doi:10.16806/j.cnki.issn.1004-3934.2019.05.013]
　ZHENG Xiaoxue,JI Fusui.Acute Kidney Injury in Patients with Acute Coronary Syndrome[J].Advances in Cardiovascular Diseases,2019,(8):713.[doi:10.16806/j.cnki.issn.1004-3934.2019.05.013]
[3]周小琳 何泉.替格瑞洛在急性冠脉综合征合并慢性肾脏病患者中的应用研究进展[J].心血管病学进展,2019,(5):718.[doi:10.16806/j.cnki.issn.1004-3934.2019.05.014]
　ZHOU Xiaolin,HE Quan.Ticagrelor in Acute Coronary Syndrome with Chronic Kidney Disease[J].Advances in Cardiovascular Diseases,2019,(8):718.[doi:10.16806/j.cnki.issn.1004-3934.2019.05.014]
[4]吕俊兴 许海燕.急性冠脉综合征危险评分的研究进展[J].心血管病学进展,2019,(9):1224.[doi:10.16806/j.cnki.issn.1004-3934.2019.09.010]
　LU Junxing,XU Haiyan.Risk Scores of Acute Coronary Syndrome[J].Advances in Cardiovascular Diseases,2019,(8):1224.[doi:10.16806/j.cnki.issn.1004-3934.2019.09.010]
[5]吕颖 胡思宁 于波 贾海波.斑块侵蚀发病机制的最新研究进展[J].心血管病学进展,2020,(1):74.[doi:10.16806/j.cnki.issn.1004-3934.2020.01.020]
　LU Ying,HU Sining,YU Bo,et al.Pathogenic Mechanisms of Plaque Erosion[J].Advances in Cardiovascular Diseases,2020,(8):74.[doi:10.16806/j.cnki.issn.1004-3934.2020.01.020]
[6]段继坤,林志,杨帆,等.斑块侵蚀引起的急性冠脉综合征的研究新进展[J].心血管病学进展,2020,(3):281.[doi:10.16806/j.cnki.issn.1004-3934.2020.03.016]
　DUAN Jikun,LIN Zhi,YANG Fan,et al.Acute Coronary Syndrome Caused by Plaque Erosion[J].Advances in Cardiovascular Diseases,2020,(8):281.[doi:10.16806/j.cnki.issn.1004-3934.2020.03.016]
[7]陈凯磊 胡闻竹 苏冠华.P2Y12抑制剂与癌症风险的相关性研究进展[J].心血管病学进展,2020,(8):798.[doi:10.16806/j.cnki.issn.1004-3934.2020.08.004]
　CHEN Kailei,HU Wenzhu,SU Guanhua.Advances in Studies on the Correlation between P2Y12 Inhibitors and Cancer Risk[J].Advances in Cardiovascular Diseases,2020,(8):798.[doi:10.16806/j.cnki.issn.1004-3934.2020.08.004]
[8]肖雨尘 赵仙先 马丽萍.急性冠脉综合征患者提前停服替格瑞洛现象的研究进展[J].心血管病学进展,2020,(11):1120.[doi:10.16806/j.cnki.issn.1004-3934.2020.11.000]
　Acute Coronary Syndrome.Premature Ticagrelor Discontinuation in Patients with[J].Advances in Cardiovascular Diseases,2020,(8):1120.[doi:10.16806/j.cnki.issn.1004-3934.2020.11.000]
[9]冯洁渊 .中性粒细胞/淋巴细胞比值和血小板/淋巴细胞比值与急性冠脉综合征的关系研究进展[J].心血管病学进展,2020,(12):1276.[doi:10.16806/j.cnki.issn.1004-3934.2020.12.013]
　 FENG Jieyuan.The Relationship Between Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio and Acute Coronary Syndrome[J].Advances in Cardiovascular Diseases,2020,(8):1276.[doi:10.16806/j.cnki.issn.1004-3934.2020.12.013]
[10]魏倩 梁岩.高敏心肌肌钙蛋白在急性冠脉综合征患者中的临床应用进展[J].心血管病学进展,2021,(5):396.[doi:10.16806/j.cnki.issn.1004-3934.2021.05.003]

更新日期/Last Update: 2024-09-13