Low High-Density Lipoprotein Cholesterol Predisposes to Coronary Artery Ectasia
Low High-Density Lipoprotein Cholesterol Predisposes to Coronary Artery Ectasia
复制标题
DOI：
10.3390/biomedicines7040079
复制
发表时间：
2019-12-01
期刊：
影响因子：
4.7
通讯作者：
Gallego-Colon, Enrique
中科院分区：
文献类型：
--
作者：
Jafari, Jamal;Daum, Aner;Gallego-Colon, Enrique
冠状动脉扩张症(CAE)是一种以一支或多支冠状动脉局部或弥漫性扩张为特征的现象。在这项研究中，分析了疑似缺血性心脏病而行心导管置入术的患者获得性冠状动脉扩张的患病率和CAE的冠状动脉危险因素。我们回顾分析了在我中心导管室接受冠状动脉造影术的4000例疑似冠心病患者，共选择171例患者。将研究组分为3组，CAE组65例，严重阻塞性冠状动脉疾病组62例，冠状动脉造影正常者44例为对照组。高密度脂蛋白胆固醇与冠脉病变呈负相关(r=-0.274，p<；0.001)。此外，高密度脂蛋白胆固醇(OR，0.858；CI，0.749~0.984；P=0.029)、低密度脂蛋白胆固醇/高密度脂蛋白胆固醇(OR，1.987；CI，1.542~2.882；P=0.034)、血红蛋白(OR，2.060；CI，1.114~3.809；P=0.021)是冠脉病变发生的独立危险因素。事实上，我们观察到，高密度脂蛋白胆固醇每增加一个单位，CAE的风险就会降低15%，而血红蛋白每增加一个单位，CAE的风险就可能增加2倍。低高密度脂蛋白胆固醇可显著增加健康个体发生CAE的风险。升高的血红蛋白容易导致随后的冠状动脉扩张和动脉瘤。这项工作表明，脂蛋白代谢紊乱或血红蛋白值改变会使患者更容易患上动脉瘤性冠状动脉疾病。
Coronary Artery Ectasia (CAE) is a phenomenon characterized by locally or diffuse coronary artery dilation of one or more coronary arteries. In the present study, the prevalence of acquired coronary ectasia and coronary risk factors for CAE was analyzed in patients undergoing cardiac catheterization for suspected ischemic heart disease. We retrospectively analyzed 4000 patients undergoing coronary angiography for suspected coronary artery disease at our cardiac catheterization unit, and a total of 171 patients were selected. The study group was divided into three groups, 65 patients with CAE, 62 patients with significant obstructive coronary artery disease, and 44 patients with normal coronary angiograms as a control group. A negative correlation was observed between high-density lipoprotein cholesterol (HDL-C) and the presence of CAE (r = -0.274, p < 0.001). In addition, HDL-C (OR, 0.858; CI, 0.749-0.984; p = 0.029), low-density lipoprotein cholesterol (LDL-C)/HDL-C ratio (OR, 1.987; CI, 1.542-2.882; p = 0.034), and hemoglobin (OR, 2.060; CI, 1.114-3.809; p = 0.021) were identified as independent risk factors for the development of CAE. In fact, we observed that a one-unit increase in HDL-C corresponded to a 15% risk reduction in CAE development and that each unit increase in hemoglobin could potentially increase the CAE risk by 2-fold. Low HDL-C could significantly increase the risk of developing CAE in healthy individuals. Elevated hemoglobin could predispose to subsequent dilation and aneurysm of the coronary artery. This work suggests that disordered lipoprotein metabolism or altered hemoglobin values can predispose patients to aneurysmal coronary artery disease.