较低低密度脂蛋白胆固醇与非糖尿病心力衰竭患者的死亡率较高有关
R Gouveia1,2, S Madureira1,2, C Elias1,2
1Internal Medicine Department, Centro Hospitalar e Universitário de São João, Porto, Portugal.
概括
低密度脂蛋白胆固醇 (LDL-c) 低于100毫克/分升,与心力衰竭 (HF) 患者没有糖尿病 (DM) 的预后恶化有关. 这一发现支持非糖尿病HF人群中的"胆固醇悖论".
科学领域:
- 心脏病学 心脏病学
- 代谢障碍 代谢障碍 代谢障碍
- 临床研究 临床研究
背景情况:
- 已确定的心力衰竭 (HF) 患者的低总胆固醇面临较差的结果.
- 关于低密度脂蛋白胆固醇 (LDL-c) 在HF的预后影响的证据有限.
- 这项研究调查了LDL-c在HF患者的预后价值,考虑到糖尿病 (DM) 状态.
研究的目的:
- 评估LDL-c水平在已确诊心力衰竭患者的预后意义.
- 为了确定LDL-c是否对患有糖尿病和没有糖尿病的HF患者的死亡率产生不同的影响.
- 为了探索世界.
- 主要_方法 方法
- 主要_结果
- 结论 结论 结论 结论
主要方法:
- 对522名患有慢性HF和缩功能障碍的门诊患者的回顾性分析.
- 使用弗里德瓦尔德公式计算的LDL-c;用100 mg/dL作为切线.
- 考克斯回归分析,根据多种临床因素进行调整,根据DM状态分层.
主要成果:
- 总共有235名 (45%) 患者在 53个月的中位数随访期间死亡.
- 患有LDL-c≤100 mg/dL的患者患有全因死亡风险增加 (HR=1.58,p=0.02).
- 在非DM患者中,LDL-c ≤100 mg/dL与死亡率增加有关 (HR=1.55,p=0.03);在DM患者中没有发现相关性 (HR=1.18,p=0.44).
结论:
- 患有LDL-c>100 mg/dL的非糖尿病HF患者的死亡风险降低了35%.
- 在HF中观察到的"胆固醇悖论"在没有糖尿病的患者中扩展到LDL-c.
- 根据糖尿病状况,LDL-c水平可能对心力衰竭有不同的预后影响.
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