Asociación en J entre la apolipoproteína B y resultados CV en pacientes con síndrome coronario crónico tratados con estatinas

IF 5.9 2区医学 Q2 Medicine

Revista espanola de cardiologia Pub Date : 2024-11-20 DOI:10.1016/j.recesp.2024.08.013

Jining He , Zhangyu Lin , Chenxi Song , Sheng Yuan , Xiaohui Bian , Bowen Li , Wenjun Ma , Kefei Dou

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Abstract

Introduction and objectives

The association between apolipoprotein B (apoB) and residual cardiovascular (CV) risk in patients with chronic coronary syndrome (CCS) remains unclear. We aimed to investigate the association between apoB levels and CV outcomes in statin-treated CCS patients.

Methods

We enrolled 8641 statin-treated CCS patients at Fuwai Hospital. The patients were divided into 5 groups based on to apoB quintiles (Q1 to Q5). The primary endpoint was 3-year CV events, including CV death, nonfatal myocardial infarction, and nonfatal stroke.

Results

During a median follow-up of 3.17 years, there were 232 (2.7%) CV events. After multivariable adjustment, a restricted cubic spline illustrated a J-shaped relationship between apoB levels and 3-year CV events, with the risk remaining flat until apoB levels exceeded 0.73 g/L, after which the risk increased (nonlinear P < .05). Kaplan-Meier curves showed the lowest CV event rate in the Q3 group (0.68-0.78 g/L). Compared with the Q3 group, multivariable Cox regression models revealed that both low (Q1, ≤ 0.57 g/L) and high (Q5, > 0.93 g/L) apoB levels were associated with an increased risk of major adverse cardiac events (all P < .05). Notably, patients with low apoB levels (Q1) had the highest risk of CV death (HR, 2.44; 95%CI, 1.17-5.08).

Conclusions

Our analysis indicates that both low and high levels of apoB are associated with elevated CV risk, with the risk being particularly pronounced at higher levels (> 0.73 g/L).

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在接受他汀类药物治疗的慢性冠状动脉综合征患者中，载脂蛋白B与CV结果之间的J相关性

慢性冠状动脉综合征（CCS）患者载脂蛋白B （apoB）与剩余心血管（CV）风险之间的关系尚不清楚。我们的目的是研究他汀类药物治疗的CCS患者载脂蛋白ob水平与CV结果之间的关系。方法选取阜外医院接受他汀治疗的CCS患者8641例。根据载脂蛋白五分位数（Q1 ~ Q5）将患者分为5组。主要终点是3年CV事件，包括CV死亡、非致死性心肌梗死和非致死性卒中。结果在3.17年的中位随访期间，共发生232例（2.7%）CV事件。多变量调整后，限制性三次样条曲线显示载脂蛋白ob水平与3年CV事件之间呈j型关系，在载脂蛋白ob水平超过0.73 g/L之前，风险保持平稳，之后风险增加(非线性P <；. 05)。Kaplan-Meier曲线显示，Q3组CV事件发生率最低（0.68-0.78 g/L）。与Q3组相比，多变量Cox回归模型显示，低（Q1,≤0.57 g/L）和高(Q5, >；0.93 g/L)载脂蛋白ob水平与主要心脏不良事件的风险增加相关(P <；. 05)。值得注意的是，低载脂蛋白ob水平（Q1）的患者CV死亡风险最高(HR, 2.44；95%可信区间,1.17 - -5.08)。结论sour分析表明，低水平和高水平载脂蛋白ob均与心血管风险升高相关，高水平载脂蛋白ob的风险尤为明显(>；0.73 g / L)。

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

Revista espanola de cardiologia 医学-心血管系统

CiteScore

4.20

自引率

13.60%

发文量

257

审稿时长

28 days

期刊介绍： Revista Española de Cardiología, Revista bilingüe científica internacional, dedicada a las enfermedades cardiovasculares, es la publicación oficial de la Sociedad Española de Cardiología.