摘要
目的:现有众多临床研究提示残余胆固醇(remnant cholesterol, RC)与心血管疾病风险紧密相关。本研究旨在此基础上,进一步探索RC与药物洗脱支架(drug-eluting stents, DES)再狭窄的相关性。方法:本研究回顾性纳入2016年1月至2020年12月,于北京市大兴区人民医院置入DES并于术后18~30个月复查冠状动脉造影的急性冠状动脉综合征(acute coronary syndrome,ACS)患者。通过造影结果,将纳入人群分为支架内再狭窄(in-stent restenosis,ISR)组与非ISR组。通过多元回归分析模型评估RC与DES-ISR的相关性。创建受试者工作特征曲线(receiver operating characteristic curve,ROC)评估RC预测DES-ISR的效应。结果:本研究共纳入603例ACS患者,其中69例在随访时发生了DES-ISR。与非DES-ISR组相比,ISR组RC浓度水平明显偏高[0.45(0.37,0.63)vs. 0.37(0.27,0.48)mmol/L,P<0.001]。单因素回归分析,RC与DES-ISR显著相关(OR=3.620,95%CI:1.817~7.211,P <0.001);校正其他混在因素后多因素回归分析模型,RC仍与DES-ISR独立相关(OR=3.255,95%CI:1.562~6.659,P=0.002)。ROC曲线分析显示,RC可有效预测ACS患者术后中远期发生DES-ISR的概率(曲线下面积=0.671,95%CI:0.605~0.736,P<0.0001)。结论:RC与ACS患者中远期DES-ISR风险独立相关。
Objective:Numerous clinical studies have suggested that remnant cholesterol(RC)is closely related to the risk of cardiovascular disease.The purpose of this study is to further explore the correlation between RC and drug eluting stents(DES)restenosis.Methods:The present study retrospectively enrolled patients with acute coronary syndrome(ACS)who underwent DES implantation in our hospital from January 2016 to December 2020 and underwent coronary angiography at 18-30 months after intervention.According to the results of coronary angiography,the enrolled population was divided into in-stent restenosis(ISR)group and non-ISR group.Subsequently,the correlation between RC and DES-ISR was evaluated using a multiple regression analysis model.Finally,a receiver operating characteristic(ROC)curve was created to evaluate the ability of RC to predict DES-ISR.Results:A total of 603 ACS patients were included in this study,of which 69 had DES-ISR during follow-up.Compared with the non-ISR group,the RC concentration level in the ISR group was significantly higher[0.45(0.37,0.63)vs.0.37(0.27,0.48mmol/L),P<0.001].In univariate regression analysis,RC was significantly correlated with DES-ISR(OR=3.620,95%CI:1.817-7.211,P<0.001);After adjusting for other mixed factors through a multivariate regression analysis model,RC remained independently correlated with DES-ISR(OR=3.255,95%CI:1.562-6.659,P=0.002).Finally,through ROC curve analysis,it was found that RC can effectively predict the probability of DES-ISR in ACS patients in the medium to long term after intervention(area under the curve=0.671,95%CI:0.605-0.736,P<0.0001).
作者
刘西霖
孟广刚
孙志民
LIU Xilin;MENG Guanggang;SUN Zhimin(Department of Emergency Internal Medicine,Beijing Daxing District People's Hospital,Beijing 102600,China)
出处
《心肺血管病杂志》
CAS
2024年第1期7-11,17,共6页
Journal of Cardiovascular and Pulmonary Diseases
关键词
残余胆固醇
药物洗脱支架
急性冠状动脉综合征
支架内再狭窄
中远期
Remnant cholesterol
Drug-eluting stents
Acute coronary syndrome
In-stent restenosis
In the medium to long term
作者简介
通信作者:孙志民,副主任医师,主要研究:急诊内科。Email:gaolouzhao396@163.com。
