Comprehensive Assessment of Lipid Markers in Cardiovascular Events Prediction

IF 1.2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

International heart journal Pub Date : 2024-09-12 DOI:10.1536/ihj.24-149

Naoya Inoue, Shuji Morikawa, Toyoaki Murohara

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Abstract

Many studies have reported a relationship between various lipids, such as cholesterol, fatty acids, and lipoproteins, and cardiovascular events. Low-density lipoprotein cholesterol (LDL-C) is often cited as a representative marker. However, there is still room for discussion regarding which markers, among other lipids, should take clinical precedence.

This observational study focused on patients without residual stenosis on post-coronary angiography. It was based on blood tests, including lipid profiles at that time, and assessed the association with the subsequent occurrence of major adverse cardiovascular events (MACE, a composite of all-cause mortality, hospitalization due to heart failure, myocardial infarction, stroke, and all revascularizations).

Of the 375 patients analyzed, 134 experienced MACE (median follow-up duration: 1031 days). When comparing the MACE and non-MACE groups, significant differences were observed in lipid markers such as non-high-density lipoprotein cholesterol (non-HDL-C) and remnant-like particle cholesterol (RLP-C) (non-HDL-C; P = 0.003, RLP-C; P < 0.001). Furthermore, the area under the curve for RLP-C was 0.656 (95% CI: 0.598-0.714). Improvement in MACE risk discrimination was observed when LDL-C was replaced with non-HDL-C or RLP-C, in addition to atherosclerosis risk factors (non-HDL-C; net reclassification improvement (NRI) = 0.366, 95% CI: 0.159-0.572, RLP-C; NRI = 0.224, 95% CI: 0.016-0.433).

It is highly likely that non-HDL-C and RLP-C can serve as significant lipid markers for predicting the occurrence of MACE.

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全面评估心血管事件预测中的血脂指标

许多研究都报告了各种血脂（如胆固醇、脂肪酸和脂蛋白）与心血管事件之间的关系。低密度脂蛋白胆固醇（LDL-C）通常被认为是具有代表性的标志物。这项观察性研究的重点是冠状动脉造影术后无残余狭窄的患者。这项观察性研究主要针对冠状动脉造影术后无残余狭窄的患者，以当时的血液检测（包括血脂情况）为基础，评估其与随后发生的主要不良心血管事件（MACE，全因死亡率、心力衰竭住院、心肌梗死、中风和所有血管再通术的综合）之间的关系。在分析的 375 例患者中，134 例发生了 MACE（中位随访时间：1031 天）。在比较MACE组和非MACE组时，观察到非高密度脂蛋白胆固醇（non-HDL-C）和残余样颗粒胆固醇（RLP-C）等血脂指标存在显著差异（non-HDL-C；P = 0.003，RLP-C；P < 0.001）。此外，RLP-C的曲线下面积为0.656（95% CI：0.598-0.714）。除动脉粥样硬化风险因素外，用非高密度脂蛋白胆固醇或高密度脂蛋白胆固醇替代低密度脂蛋白胆固醇时，MACE 风险分辨能力也有所提高（非高密度脂蛋白胆固醇；净再分类改进（NRI）= 0.366，95% CI：0.159-0.572；高密度脂蛋白胆固醇；NRI= 0.224，95% CI：0.016-0.433）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International heart journal 医学-心血管系统

CiteScore

2.50

自引率

6.70%

发文量

148

审稿时长

6-12 weeks

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