急性心肌梗死患者高密度脂蛋白胆固醇亚类比例与冠状动脉狭窄严重程度之间的关系

IF 3.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Journal of clinical lipidology Pub Date : 2024-09-01 DOI:10.1016/j.jacl.2024.06.003

Yu Geng PhD , Bin Wang MD , Lianfeng Liu PhD , Changhua Lv BD, Hao Qian PhD, Tingting Lv PhD, Ping Zhang MD

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引用次数: 0

摘要

背景过去的研究表明，高密度脂蛋白（HDL）与冠心病（CHD）之间存在反相关性，而最近的研究表明，极高或极低的高密度脂蛋白水平会增加心血管死亡的风险。目的探讨急性心肌梗死（AMI）患者中高密度脂蛋白亚型与冠状动脉狭窄程度之间的关系。最终，我们纳入了 1200 名在 2017 年至 2023 年期间住院治疗的急性心肌梗死成年参与者。根据 Gensini 评分将患者分为轻度组和中度严重组。结果在多变量逻辑模型（调整了年龄、性别、高血压状态、糖尿病状态、中风状态和肾脏疾病状态）中，HDL亚类的调整赔率（OR）、95%置信区间（CI）和P值如下：HDL-2b：0.97（0.95-1.00，p= 0.018），HDL-3：0.98（0.97-0.99，p= 0.008）。亚组分析表明，HDL-3对75岁以上人群和男性冠状动脉狭窄严重程度的影响具有统计学意义，而HDL-2b对冠状动脉狭窄严重程度的影响仅对年龄≥75岁的人群具有统计学意义。亚组分析确定了需要关注 HDL-2b 和 HDL-3 的特定人群。

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Association between the proportion of HDL-cholesterol subclasses and the severity of coronary artery stenosis in patients with acute myocardial infarction

BACKGROUND

Past research has shown an inverse correlation between high-density lipoprotein (HDL) and coronary heart disease (CHD), while recent studies have shown that extremely high or low HDL levels increase the risk of cardiovascular death.

OBJECTIVE

To explore the relationships between HDL subtypes and the degree of coronary artery stenosis in patients with acute myocardial infarction (AMI).

METHODS

This was a single-center cross-sectional study. Ultimately, we included 1,200 adult participants with AMI hospitalized from 2017 to 2023. Patients were classified into mild and moderate-severe groups according to their Gensini score. Restricted cubic spline and multivariate logistic regression models were used to explore the associations between HDL subclasses and the severity of coronary stenosis.

RESULTS

The adjusted odds ratios (ORs), 95% confidence intervals (CIs), and p values for HDL subclasses in the multivariate logistic model (adjusted for age, gender, hypertension status, diabetes status, stroke status, and kidney disease status) were as follows: HDL-2b: 0.97 (0.95–1.00, p= 0.018) and HDL-3: 0.98 (0.97–0.99, p= 0.008). Subgroup analysis revealed that HDL-3 exhibited a statistically significant impact on the severity of coronary stenosis among individuals <75 years of age and among men, and the influence of HDL-2b on the severity of coronary stenosis was statistically significant only in individuals aged ≥75 years.

Conclusion

The relationship between reduced levels of HDL-2b and HDL-3 and the risk of coronary stenosis exhibited a linear pattern and was significantly modified by age. Subgroup analysis identified specific populations that warrant attention regarding HDL-2b and HDL-3.

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来源期刊

Journal of clinical lipidology 医学-药学

CiteScore

7.00

自引率

6.80%

发文量

209

审稿时长

49 days

期刊介绍： Because the scope of clinical lipidology is broad, the topics addressed by the Journal are equally diverse. Typical articles explore lipidology as it is practiced in the treatment setting, recent developments in pharmacological research, reports of treatment and trials, case studies, the impact of lifestyle modification, and similar academic material of interest to the practitioner. While preference is given to material of immediate practical concern, the science that underpins lipidology is forwarded by expert contributors so that evidence-based approaches to reducing cardiovascular and coronary heart disease can be made immediately available to our readers. Sections of the Journal will address pioneering studies and the clinicians who conduct them, case studies, ethical standards and conduct, professional guidance such as ATP and NCEP, editorial commentary, letters from readers, National Lipid Association (NLA) news and upcoming event information, as well as abstracts from the NLA annual scientific sessions and the scientific forums held by its chapters, when appropriate.