非高密度脂蛋白胆固醇在预测高风险亚洲人心血管事件方面优于低密度脂蛋白胆固醇
Worapaka Manosroi1, Phichayut Phinyo2, Mattabhorn Phimphilai3
1Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand (Drs Manosroi and Phimphilai); Faculty of Medicine, Center for Clinical Epidemiology and Clinical Statistics, Chiang Mai University, Chiang Mai, Thailand (Drs Manosroi and Phinyo).
Journal of clinical lipidology
|March 6, 2025
概括
对于接受他类药物治疗的心血管疾病患者,非高密度脂蛋白胆固醇 (非HDL-C) 比低密度脂蛋白胆固醇 (LDL-C) 更好地预测主要的心脏不良事件. 非HDL-C是减少残留心血管风险的关键目标.
科学领域:
- 心脏病学 心脏病学
- 脂质代谢 脂质代谢是什么
- 预防医学 预防医学
背景情况:
- 非高密度脂蛋白胆固醇 (非HDL-C) 与心血管结果的关联比低密度脂蛋白胆固醇 (LDL-C) 更强.
- 关于非HDL-C在接受他类药物治疗的亚洲人群中心血管事件的预测能力的数据有限.
- 这项研究调查了在接受他类药物治疗的患者中长期重大心脏不良事件 (MACE) 的非HDL-C和LDL-C的比较可预测性.
研究的目的:
- 为了比较非HDL-C与LDL-C在预测长期3点主要不良心脏事件 (3P-MACE) 的疗效.
- 评估非HDL-C作为治疗他类药物的动脉样硬化心血管疾病 (ASCVD) 患者的残留心血管风险管理的主要目标.
主要方法:
- 利用了来自"CORE-泰国研究"的数据,这是ASCVD或高风险患者的多中心国家注册表.
- 主要结局被定义为3P-MACE (所有原因死亡率,非致命的心肌梗塞,非致命中风).
- 采用Cox比例危险回归模型来分析非HDL-C,LDL-C四分位数和3P-MACE之间的关联.
主要成果:
- 包括6978名非HDL-C数据的患者和7365名LDL-C数据的患者.
- 在完全调整的模型中,高的非HDL-C,特别是在最高四分位数中,显著预测了3P-MACE (HR: 1.676,P=.002).
- LDL-C与3P-MACE没有显著的关联;趋势表明,在调整为非HDL-C时,较高的LDL-C与较低的MACE风险相比,LDL-C更高.
结论:
- 在接受他类药物治疗的高风险ASCVD患者中,非HDL-C是3P-MACE的显著预测因子,表现优于LDL-C.
- 非HDL-C应被视为主要的治疗目标,以减轻该患者群体的残留心血管风险.
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