摘要
目的:评估脂蛋白a[Lp(a)]与急性冠状动脉综合征(ACS)患者PCI后疗效关系。方法:接受PCI治疗的ACS患者1192例被分为低Lp(a)组(<30mg/dl,516例)和高Lp(a)组(≥30mg/dl,676例)。分析Lp(a)水平与患者临床资料、冠脉病变特征等的关系。结果:与低Lp(a)组相比,高Lp(a)组冠脉病变血管支数[(1.43±0.48)支比(1.61±0.62)支]、病变长度[(25.38±0.52)mm比(27.62±6.77)mm]、SYNTAX评分[(17.71±4.59)分比(21.23±5.62)分],置入支架数[(1.81±0.62)个比(1.91±0.65)个]均显著增加,左前降支病变(50.39%比67.60%)、PCI前TIMI血流0级(34.80%比41.22%)、PCI后TIMI血流2级(4.11%比9.63%)、冠脉C型病变(24.42%比33.73%)比例,以及糖蛋白Ⅱb/Ⅲa抑制剂使用率(7.17%比12.28%),住院期间临床事件总发生率显著升高(15.89%比22.19%),P<0.05或<0.01。Logistic多元回归分析显示,高Lp(a)水平与狭窄血管数(OR=1.34)、C型冠脉病变(OR=1.24)、PCI前TIMI血流0~1级(OR=1.22)、PCI后TIMI血流2级(OR=1.191)、住院期间心力衰竭(OR=1.40)和综合临床事件(OR=1.43)显著相关(P<0.05或<0.01)。结论:接受PCI治疗的高Lp(a)水平ACS患者冠脉病变较严重,住院期间心力衰竭和综合临床事件的风险较高。
Objective:To evaluate the relationship between lipoprotein(a)(Lp(a))and therapeutic effect of patients with acute coronary syndrome(ACS)after PCI.Methods:A total of 1192 ACS patients undergoing PCI were divided into low Lp(a)group(<30mg/dl,n=516)and high Lp(a)group(≥30mg/dl,n=676).Relationship among clinical data,coronary lesion features etc and Lp(a)level were analyzed.Results:Compared with the low Lp(a)group,there were significant rise in number of diseased coronary vessels[(1.43±0.48)vs.(1.61±0.62)],lesion length[(25.38±0.52)mm vs.(27.62±6.77)mm],SYNTAX score[(17.71±4.59)scores vs.(21.23±5.62)scores],number of implanted stents[(1.81±0.62)vs.(1.91±0.65)],left anterior descending artery lesion(50.39%vs.67.60%),percentages of TIMI grade 0 before PCI(34.80%vs.41.22%),TIMI grade 2 after PCI(4.11%vs.9.63%),coronary type C lesion(24.42%vs.33.73%)and usage rate of glycoproteinⅡb/Ⅲa inhibitor(7.17%vs.12.28%),total incidence rate of in-hospital clinical events(15.89%vs.22.19%,)in.high Lp(a)group,P<0.05 or<0.01.Multivariate Logistic regression analysis indicated that high Lp(a)level was associated with number of stenotic vessels(OR=1.34),coronary type C lesion(OR=1.24),TIMI grade 0~1 before PCI(OR=1.22),TIMI grade 2 after PCI(OR=1.191),in-hospital heart failure(OR=1.40)and general clinical events(OR=1.43),P<0.05 or<0.01.Conclusion:Coronary lesion is quite serious in ACS patients with high Lp(a)level undergoing PCI.Risk of in-hospital heart failure and general clinical events is high in these patients.
作者
蔡少娜
陈晓晴
戴增欢
胡彦
洪鹭蓉
黄文莉
CAI Shao-na;CHEN Xiao-qing;DAI Zeng-huan;HU Yan;HONG Lu-long;HUANG Wen-li(Department of Cardiology,909 th Hospital of Joint Logistics Support Force of Chinese PLA,Zhangzhou,Fujian,363000,China)
出处
《心血管康复医学杂志》
CAS
2022年第1期22-28,共7页
Chinese Journal of Cardiovascular Rehabilitation Medicine
