残余胆固醇与急性冠状动脉综合征患者心血管结结局局的的相相关关性性:一项回顾性研究

Correlation of remnant cholesterol with cardiovascular outcomes in patients with acute coronary syndromes:a retrospective study

目的探讨残余胆固醇(RC)对急性冠状动脉综合征患者长期预后的影响。方法纳入2017年1月至2021年1月于新疆医科大学第一附属医院心脏中心行经皮冠状动脉介入术(PCI)的急性冠状动脉综合征患者1943例,根据患者残余胆固醇(RC)三分位数将患者分为RC低水平组(≤0.28 mmol/L,n=553)、RC中水平组(0.28~0.54 mmol/L,n=563)和RC高水平组(≥0.54 mmol/L,n=560)。主要终点为主要不良心血管事件(MACCE),包含全因死亡、心肌梗死、卒中和非计划血运重建。结果经过中位随访时间67(60,73)个月,共193例患者出现MACCE事件,其中,低水平组62例,中水平组72例,高水平组59例,RC中水平组(12.8%比11.2%,HR=1.152,95%CI 0.817~1.622)和RC高水平组(10.5%比11.2%,HR=0.957,95%CI 0.667~1.374)患者MACCE发生率相较于RC低水平组无统计学差异(P>0.05)。与RC低水平组患者相比,RC高水平组患者病死率更低(0.2%比0.5%;HR=0.336,95%CI 0.035~3.231)。但Cox多因素分析校正混杂因素后发现,RC水平不是患者MACCE和死亡的独立预测因素。结论在接受PCI的急性冠状动脉综合征患者中,RC水平与患者的心血管事件发生率之间无明显相关性。

Objective To investigate the effect of remnant cholesterol(RC)on the long-term prognosis of patients with acute coronary syndromes.Methods Inclusion of 1,943 patients with acute coronary syndromes who underwent percutaneous coronary intervention(PCI)at the Heart Centre of the First Affiliated Hospital of Xinjiang Medical University from January 2017 to January 2021,and the patients were divided into the low level of RC group(≤0.28 mmol/L,n=553),the medium level of RC group(0.28~0.54 mmol/L,n=563)and high RC group(≥0.54 mmol/L,n=560).The primary endpoint was major adverse cardiovascular and cerebrovascular events(MACCE),including all-cause death,myocardial infarction,stroke and unplanned haemodialysis.Results After a median follow-up time of 67(60,73)months,a total of 193 patients developed MACCE events,of which 62 were in the low-level group,72 in the intermediate-level group,and 59 in the high-level group,and there were no significant differences between patients in the intermediate-level group of RC(12.8%vs.11.2%,HR=1.152,95%CI 0.817-1.622)and the high-level group of RC(10.5%vs.11.2%,HR=0.957,95%CI 0.667-1.374).There was no statistically significant difference in the incidence of MACCE in patients in the low RC group(10.5%vs.11.2%,HR=0.957,95%CI 0.667-1.374)compared with the low RC group(P>0.05).Patients in the high-level RC group had a lower mortality rate compared with patients in the low-level RC group(0.2%vs.0.5%;HR=0.336,95%CI 0.035-3.231).However,Cox multifactorial analysis corrected for confounders found that RC level was not an independent predictor of MACCE and death in patients.Conclusions In patients with acute coronary syndromes undergoing PCI,there was no significant correlation between RC levels and the incidence of cardiovascular events in patients.