血清酸盐水平与冠状动脉疾病患者心血管事件发生率之间的关系
Marcello Tonelli1, Frank Sacks, Marc Pfeffer
1Department of Medicine, University of Alberta, Edmonton, Alberta, Canada. mtonelli@ualberta.ca
Circulation
|October 26, 2005
概括
高血清酸盐水平,即使在正常范围内,也与先前心肌梗塞患者死亡和心血管事件风险增加有关. 这一发现可能在临床上有用,因为酸盐测试的易用性和低成本.
科学领域:
- 心血管医学 心血管医学
- 临床化学 临床化学
- 流行病学 流行病学
背景情况:
- 血清酸盐升高是心血管疾病的已知危险因素,特别是在高酸盐血症中.
- 血清酸盐水平在正常范围内对心血管结果的潜在影响仍然不太清楚.
研究的目的:
- 为了研究基线血清酸盐水平和前史心肌梗塞患者不良临床结果之间的关联.
- 为了确定血清酸盐水平是否在正常范围内,预测心血管事件和死亡率.
主要方法:
- 胆固醇和复发事件 (CARE) 研究数据的后期分析.
- 包括4127名禁食参与者,随机分配给普拉瓦斯塔丁或安慰剂.
- 使用考克斯的比例危险模型来评估血清酸盐与结果之间的关系,调整以考虑混因素.
主要成果:
- 在基线水平较高的血清酸盐与因任何原因死亡风险增加之间发现了显著的关联.
- 血清酸盐水平和死亡率之间观察到一个分级的,独立的关系 (P趋势=0.03).
- 较高的酸盐水平与心力衰竭,心肌梗塞和冠状动脉死亡的风险增加有关,而不是中风.
结论:
- 较高的血清酸盐水平,即使在正常范围内,也与先前心肌梗塞患者的死亡和心血管事件风险增加有关.
- 这些发现表明,血清酸盐测量可能是一个有价值和具有成本效益的临床工具.
- 进一步的研究可能会阐明将正常范围酸盐与不良心血管结果联系在一起的机制.
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