脂蛋白a与急性ST段抬高型心肌梗死患者经皮冠状动脉介入手术后1年内发生主要不良心血管事件的相关性

To Explore the Correlation between Lipoprotein a and MACE in Patients with Acute ST Segment Elevation Myocardial Infarction within 1 year after PCI

目的:探讨行经皮冠状动脉介入手术(PCI)的急性ST段抬高型心肌梗死(STEMI)患者中脂蛋白a[Lp(a)]水平与术后1年内发生主要不良心血管事件(MACE)的相关性。方法:选取2020年9月—2021年8月在益阳市中心医院行急诊PCI,并在1年后完成随访的STEMI患者202例为研究对象,将1年内发生MACE情况进行登记,通过单因素、多因素两种统计分析予以相关性比较。结果:202例患者中,发生MACE 24例,发生率为11.89%,将患者Lp(a)以50 mg/dL为界点分为两组,结果表明Lp(a)>50 mg/dL组MACE发生率高于Lp(a)≤50mg/dL组,差异有统计学意义(P<0.001)。Cox风险比例回归模型结果表明,作为定量变量,Lp(a)增高是STEMI患者PCI术后1年发生MACE的危险要素;作为分类变量,PCI术后1年STEMI患者发生MACE也与Lp(a)>50 mg/dL呈正相关。结论:Lp(a)水平越高提示PCI术后1年内STEMI患者的MACE发生率越高,对于PCI术后STEMI患者的治疗,需要控制Lp(a)的水平。

Objective:To investigate the association between lipoprotein a[Lp(a)]levels and major adverse cardiovascular events(MACE)in patients with acute ST elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI)within 1 year after surgery.Methods:A total of 202 STEMI patients who underwent emergency PCI were selected at Yiyang Central Hospital from September 2020 to August 2021,and completed follow-up after one year,the MACE situation within one year was registered.Statistical analysis of factors and multi-factors was used to compare the correlations.Results:Among the 202 patients,MACE occurred in 24 cases,with an incidence rate of 11.89%.The patients were divided into two groups with Lp(a)50 mg/dL as the cut-off point.The results showed that the incidence of MACE in the Lp(a)>50 mg/dL group was Higher than Lp(a)≤50 mg/dL group,the difference was statistically significant(P<0.001).The results of the Cox proportional hazard regression model showed that as a quantitative variable,increased Lp(a)was a risk factor for MACE in STEMI patients 1 year after PCI;as a categorical variable,MACE in STEMI patients 1 year after PCI was also associated with Lp(a)>50 mg/dL was positively correlated.Conclusion:A higher level of Lp(a)indicates a higher incidence of MACE in STEMI patients within 1 year after PCI.It is necessary to control the level of Lp(a)of STEMI patients after PCI.