采用血栓切除术治疗缺血性脑卒中患者的血脂谱和心房颤动：意大利一家三级脑卒中医院的经验。

Q2 Medicine

Cardiovascular and Hematological Agents in Medicinal Chemistry Pub Date : 2024-01-01 DOI:10.2174/1871525721666230522124351

Maria Cristina Bravi, Fabio Pilato, Domenica Crupi, Marilena Mangiardi, Francesca Romana Pezzella, Antonio Siniscalchi, Enrico Cotroneo, Luca Bertaccini, Michele Alessiani, Sabrina Anticoli

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We also examined the association between lipid profile, AF and EVT in multivariate logistic regression analysis.Results: Median age of patients was 74 years, 54.9% were males (95% CI 52.5-57.4%), and 26.8% (95% CI, 24.7-29.0%) had AF. EVT patients (n = 370; 22.57 %; 95% CI, 20.6-24.7) showed no difference in age (median 73 years (IQR; 63-80) versus 74 years (IQR; 63-82)), HbA1c levels (median 5.8 (IQR; 5.4-6.2) versus 5.9 (IQR; 5.4-6.4)), TG/HDL ratio (median 2.40 (IQR; 1.65-3.48) versus 2.51 (IQR; 1.73-3.64)), diabetes (OR 0.82; 95% CI 0.61 to 1.08), hypertension (OR 0.87; 95% CI 0.68 to 1.12) and obesity (OR 1.06; 95% CI 0.78 to 1.42) compared to non-EVT patients. 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引用次数: 0

摘要

目的评估接受血栓切除术（EVT）治疗的急性缺血性脑卒中（AIS）患者的急性血脂情况、心房颤动和其他心血管风险因素：我们对2016年1月至2021年12月期间连续1639例急性缺血性卒中患者的血脂概况和血管风险因素进行了回顾性分析。为了评估血脂状况，我们在患者入院后第二天进行了实验室检测，包括总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）和甘油三酯（TG）。我们还通过多变量逻辑回归分析研究了血脂状况、房颤和 EVT 之间的关系：患者的中位年龄为 74 岁，54.9% 为男性（95% CI 52.5-57.4%），26.8%（95% CI，24.7-29.0%）患有房颤。EVT 患者（n = 370；22.57%；95% CI，20.6-24.7）在年龄（中位数 73 岁（IQR；63-80）对 74 岁（IQR；63-82））、HbA1c 水平（中位数 5.8（IQR；5.4-6.2）对 5.9（IQR；5.4-6.4））、TG/HDL 比值（中位数 2.40（IQR；1.65-3.48）对 2.51（IQR；1.73-3.64））、糖尿病（OR 0.82；95% CI 0.61-1.08）、高血压（OR 0.87；95% CI 0.68-1.12）和肥胖（OR 1.06；95% CI 0.78-1.42）。相反，EVT 患者的总胆固醇水平较低（160 mg/dl (IQR; 139- 187) 对 173 mg/dl (IQR; 148-202); p 对 113 mg/dl (IQR; 88-142); p 对 107 mg/dl (IQR; 85-139); p 对 127 mg/dl (IQR; 103-154); p 对 10 mmol/l (IQR; 7.3-13.5); p 结论：与其他脑卒中患者相比，接受血栓切除术的患者总胆固醇和所有与胆固醇相关的指标均显著降低。相反，我们发现 EVT 患者的房颤明显较高，这表明高胆固醇血症可能主要与小血管闭塞性卒中有关，而大血管闭塞（LVO）卒中可能有不同的病因。AIS患者可能有不同的发病机制，对他们的了解可能有助于发现有针对性的预防治疗方法。

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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Lipid Profiles and Atrial Fibrillation in Ischemic Stroke Patients Treated with Thrombectomy: Experience from a Tertiary Italian Stroke Hospital.

Objectives: To assess acute lipid profiles, atrial fibrillation and other cardiovascular risk factors in patients undergoing treatments by thrombectomy (EVT) with acute ischemic stroke (AIS).

Methods: We performed a retrospective analysis of the lipid profile and vascular risk factor in 1639 consecutive patients with acute ischemic stroke between January 2016 and December 2021. To assess lipid profiles, laboratory tests, including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG), were obtained the day after admission. We also examined the association between lipid profile, AF and EVT in multivariate logistic regression analysis.

Results: Median age of patients was 74 years, 54.9% were males (95% CI 52.5-57.4%), and 26.8% (95% CI, 24.7-29.0%) had AF. EVT patients (n = 370; 22.57 %; 95% CI, 20.6-24.7) showed no difference in age (median 73 years (IQR; 63-80) versus 74 years (IQR; 63-82)), HbA1c levels (median 5.8 (IQR; 5.4-6.2) versus 5.9 (IQR; 5.4-6.4)), TG/HDL ratio (median 2.40 (IQR; 1.65-3.48) versus 2.51 (IQR; 1.73-3.64)), diabetes (OR 0.82; 95% CI 0.61 to 1.08), hypertension (OR 0.87; 95% CI 0.68 to 1.12) and obesity (OR 1.06; 95% CI 0.78 to 1.42) compared to non-EVT patients. Conversely, EVT patients showed lower levels of TC (160 mg/dl (IQR; 139- 187) versus 173 mg/dl (IQR; 148-202); p <0.001), LDL-C (105 mg/dl (IQR; 80-133) versus 113 mg/dl (IQR; 88-142); p <0.01), TG (98 mg/dl (IQR; 76-126) versus 107 mg/dl (IQR; 85-139); p <0.001), non-HDL-C (117 mg/dl (IQR; 94-145) versus 127 mg/dl (IQR; 103-154); p <0.001), HC (8.3 mmol/l (IQR; 6-11) versus 10 mmol/l (IQR; 7.3-13.5); p <0.001) than non-EVT patients. Multivariate logistic regression analysis showed an independent association of EVT with TC (OR 0.99, 95% CI 0.98-0.99), AF (OR 1.79, 95% CI 1.34-2.38), age (OR 0.98, 95% CI 0.96-0.99), and NIHSS (OR 1.17, 95% CI 0.14-1.19).

Conclusion: Total cholesterol and all cholesterol-related measures were significantly lower in patients undergoing thrombectomy than in other stroke patients. Conversely, we found that AF was significantly high in patients with EVT, suggesting that hypercholesterolemia could be mainly linked to small-vessel occlusion stroke while large vessel occlusion (LVO) stroke could show different causes. AIS patients may have different pathogenesis and their understanding may improve the discovery of specific and tailored preventive treatments.

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来源期刊

Cardiovascular and Hematological Agents in Medicinal Chemistry Medicine-Cardiology and Cardiovascular Medicine

CiteScore

2.70

自引率

0.00%

发文量

期刊介绍： Cardiovascular & Hematological Agents in Medicinal Chemistry aims to cover all the latest and outstanding developments in medicinal chemistry and rational drug design for the discovery of new Cardiovascular & Hematological Agents. Each issue contains a series of timely in-depth reviews written by leaders in the field covering a range of current topics in Cardiovascular & Hematological medicinal chemistry. Cardiovascular & Hematological Agents in Medicinal Chemistry is an essential journal for every medicinal chemist who wishes to be kept informed and up-to-date with the latest and most important developments in cardiovascular & hematological drug discovery.