血栓形成因子和复发性冠状动脉事件
A J Moss1, R E Goldstein, V J Marder
1Cardiology and Vascular Medicine, Department of Medicine, University of Rochester School of Medicine, Rochester, NY, USA.
Circulation
|May 20, 1999
概括
升高的D-二聚体和apoB,以及低的apoA-I,预测心肌梗塞后患者的冠状动脉复发事件. 这些血液因子表明有前凝性状态和脂质运输失调,增加风险.
科学领域:
- 心血管医学 心血管医学
- 血液学 血液学 血液学
- 临床生物化学 临床生物化学
背景情况:
- 血栓形成是冠状动脉疾病病原体的核心.
- 确定心肌梗塞后复发事件的危险因素至关重要.
研究的目的:
- 调查血栓和血脂因子与心肌梗塞后患者的复发性冠状动脉事件之间的关联.
主要方法:
- 预计将在心肌梗塞发生2个月后招募1045名患者.
- 测量血液静态 (D-二聚合物,纤维素,因子VII,因子VIIa,·威尔布兰德因子,PAI-1),脂质 (胆固醇,甘油三,高密度胆固醇,低密度胆固醇,低密度胆固醇,低密度胆固醇,低密度胆固醇,低密度胆固醇,低密度胆固醇) 和胰岛素水平.
- 平均26个月的随访,冠状动脉死亡或非致命的心肌梗塞作为主要终点;使用Cox生存模型.
主要成果:
- 高水平的D-二次体 (HR 2.43) 独立地与复发事件相关.
- 高的apoB水平 (HR 1.82) 和低的apoA-I水平 (HR 1.84) 也独立地与风险增加有关.
- 在对临床共变量进行调整后,关联仍然显著.
结论:
- 升高的D-二聚体表明一种促凝剂状态,有助于重复性冠状动脉事件.
- 脂质运输障碍,以低的apoA-I和高的apoB表现,独立地增加了心脏病发作后患者的风险.
- 这些生物标志物为二次预防策略提供了有价值的见解.
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