Association between discordance of LDL-C and non-HDL-C and clinical outcomes in patients with stent implantation: from the FU-Registry
Association between discordance of LDL-C and non-HDL-C and clinical outcomes in patients with stent implantation: from the FU-Registry
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DOI：
10.1007/s00380-017-1036-x
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发表时间：
2018-02-01
影响因子：
1.5
通讯作者：
Saku, Keijiro
中科院分区：
文献类型：
--
作者：
Shiiba, Michiyo;Zhang, Bo;Saku, Keijiro
目前尚不清楚低密度脂蛋白胆固醇（LDL-C）和非高密度脂蛋白胆固醇（non-HDL-C）的不一致性是否可以预测冠状动脉支架植入患者的随访临床结局（主要不良心血管事件：MACE）。2015例冠状动脉支架植入患者中（福冈大学[FU]-注册），排除急性冠脉综合征或血液透析患者，我们选择了801例成功接受支架植入术并随访至18个月的患者，并根据基线LDL-C和非HDL-C水平将其分为3组[百分位数（P）非HDL-C高于（P）LDL-C，（P）非HDL-C等于（P）LDL-C，（P）非HDL-C小于（P）LDL-C]。我们发现，（P）LDL-C和（P）非HDL-C的不一致性不是MACE的显著预测因子。通过多变量考克斯回归分析，在控制了传统风险因素和所用支架类型后，较高的LDL-C水平与较高的MACE发生率一致且独立相关。总之，LDL-C水平比非HDL-C水平更重要，LDL-C和非HDL-C水平的不一致性作为支架植入术后稳定型心绞痛患者MACE的预测因子。
It is not yet clear whether the discordance of low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) predicts the follow-up clinical outcome (major adverse cardiovascular events: MACEs) in patients with coronary stent implantation. Among 2015 patients with coronary stent implantation (Fukuoka University [FU]-Registry), excluding those with acute coronary syndrome or hemodialysis, we selected 801 patients who had undergone successful stent implantation with a follow-up until 18 months, and classified them into 3 groups according to baseline LDL-C and non-HDL-C levels [percentile(P)non-HDL-C more than (P)LDL-C, (P)non-HDL-C equal to (P)LDL-C, and (P)non-HDL-C less than (P) LDL-C]. We found that the discordance of (P)LDL-C and (P)non-HDL-C was not a significant predictor of MACEs. Higher LDL-C level was consistently and independently associated with higher incidences of MACEs after controlling for conventional risk factors and the type of stent used by multivariate Cox regression analyses. In conclusion, LDL-C levels are more important than non-HDL-C levels and the discordance of LDL-C and non-HDL-C levels as predictors of MACEs in patients with stable angina after stent implantation.