ApoA-1表达与重组人脑钠肽治疗急性心肌梗死的不良心血管事件相关性分析

Correlation between apolipoprotein A-1 expression and major adverse cardiovascular events of acuter myocardial infarction treated with recombinant human brain natriuretic peptide

目的研究血浆载脂蛋白A-1(ApoA-1)表达与重组人脑钠肽治疗急性心肌梗死(AMI)的不良心血管事件相关性。方法回顾性分析2021年3月至2023年2月于陕西中医药大学第二附属医院心内科进行重组人脑钠肽治疗的AMI患者132例,根据是否发生不良心血管事件分为发生组(n=19)和未发生组(n=113)。从脑卒中、心源性死亡、再发性心肌梗死、心绞痛发作四种结局分别分析与ApoA-1表达的相关性。对AMI患者重组人脑钠肽治疗后发生不良心血管事件进行单因素、多因素Logistic回归分析,探究ApoA-1表达水平与重组人脑钠肽治疗AMI的不良心血管事件相关性。结果与发生组相比,未发生组ApoA-1表达水平更高,具有统计学差异(P<0.05);与发生组相比,未发生组左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、血肌酐(SCr)、尿素氮(BUN)水平降低,左心室射血分数(LVEF)、肾小球滤过率(eGFR)水平均升高,具有统计学差异(P<0.05)。心源性死亡组、再发性心肌梗死组、脑卒中组、心绞痛发作组的ApoA-1水平明显低于不良心血管事件未发生组,各亚组间的脂质代谢指标均具有统计学差异(P<0.05)。Logistic回归分析显示,空腹血糖(FBG)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、ApoA-1水平变化是影响AMI患者重组人脑钠肽治疗后发生心源性死亡、再发性心肌梗死、脑卒中、心绞痛发作的危险因素,具有统计学差异(P<0.05)。通过Pearson分析得出,ApoA-1表达与重组人脑钠肽治疗AMI的心源性死亡、再发心肌梗死、脑卒中、心绞痛发作不良心血管事件均呈正相关,具有统计学差异(P<0.05)。结论ApoA-1表达水平异常是造成AMI患者进行重组人脑钠肽治疗后发生不良心血管事件的危险因素。

Objective To study the correlation between expression of apolipoprotein A-1(ApoA-1)and major adverse cardiovascular events(MACE)of acuter myocardial infarction(AMI)treated with recombinant human brain natriuretic peptide(rhBNP).Methods AMI patients(n=132)treated with rhBNP were retrospectively analyzed in Department of Cardiology in the Second Affiliated Hospital of Shaanxi University of Chinese Medicine from Mar.2021 to Feb.2023,and the patients were divided,according to whether MACE occurred or not,into MACE group(n=19)and non-MACE group(n=113).The correlation among ApoA-1 expression and 4 outcomes including stroke,cardiac death,relapsed myocardial infarction and angina pectoris(AP)was analyzed.The incidence of MACE was analyzed by using single-factor and multi-factor Logistic regression analyses in AMI patients after rhBNP treatment.The correlation between ApoA-1 expression and MACE after rhBNP treatment was studied.Results The level of ApoA-1 expression was higher in MACE group than that in non-MACE group(P<0.05).The levels of left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),serum creatinine(SCr)and blood urea nitrogen(BUN)decreased,and levels of left ventricular ejection fraction(LVEF)and glomerular filtration rate(GFR)increased in MACE group compared with non-MACE group(P<0.05).The level of ApoA-1 expression in cardiac death group,relapsed myocardial infarction group,stroke group and AP group was significantly lower than that in non-MACE group(P<0.05).The results of Logistic regression analyses showed that fasting blood glucose(FBG),triglyceride(TG),low-density lipoprotein-cholesterol(LDL-C)and ApoA-1 expression level were risk factors affecting cardiac death,relapsed myocardial infarction,stroke and AP in AMI patients after rhBNP treatment(P<0.05).The results of Pearson analysis showed that ApoA-1 expression was positively correlated to MACE(cardiac death,relapsed myocardial infarction,stroke and AP)in AMI patients after rhBNP treatment(P<0.05).Conclusion The level of ApoA-1 expression is a risk factor affecting MACE occurrence in AMI patients after rhBNP treatment.