Coronary artery disease in patients at low risk - apolipoprotein AI as an independent risk factor
Coronary artery disease in patients at low risk - apolipoprotein AI as an independent risk factor
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DOI：
10.1016/s0021-9150(00)00528-1
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发表时间：
2001-03-01
期刊：
影响因子：
5.3
通讯作者：
Frohlich, JJ
中科院分区：
文献类型：
--
作者：
Francis, MC;Frohlich, JJ
冠状动脉疾病（CAD）的许多危险因素已被大型流行病学研究确定。然而，一些没有主要危险因素的患者仍然会发生疾病。对没有与CAD相关的主要危险因素的接受血管造影的个体进行的初步分析表明，血管造影阳性的患者载脂蛋白AI（apoAI）显著较低。提出apoAI是低危人群CAD的独立危险因素的假说。1075例连续患者接受了血管造影、血脂分析，并完成了危险因素问卷调查。选择总胆固醇< 5.2 mmol/l、高密度脂蛋白（HDL）-胆固醇> 0.9 mmol/l、收缩压< 140 mmHg和舒张压< 90 mmHg、无糖尿病、一级亲属中无早发CAD家族史的个体。54例患者符合这些选择标准：29例有CAD的阳性证据，25例无疾病证据。多因素分析显示，在调整年龄和性别后，血清apoAI水平是CAD的唯一预测变量。这种效应与HDL胆固醇水平和HDL的酯化率无关。这些结果表明apoAI在动脉粥样硬化形成过程中起重要作用，特别是在没有主要CAD危险因素的人群中。apoAI或LpAI水平降低可能在高度选择的低风险患者组中引发动脉粥样硬化。(C)2001爱思唯尔科学爱尔兰有限公司版权所有。
Many risk factors for coronary artery disease (CAD) have been established by large epidemiological studies. However, some patients without the major risk factors still develop disease. Preliminary analysis of individuals referred for angiography, who had no major risk factors associated with CAD, indicated that apolipoprotein-AI (apoAI) was significantly lower in patients with positive angiograms. The hypothesis that apoAI was an independent risk factor for CAD in low risk populations was put forth. One thousand and seventy-five consecutive patients underwent angiography, lipid analysis, and completed a risk factor questionnaire. Individuals with total cholesterol < 5.2 mmol/l, high density lipoprotein (HDL)-cholesterol > 0.9 mmol/l, systolic blood pressure < 140 mmHg and diastolic blood pressure < 90 mmHg, no diabetes, and no family history of premature CAD in first degree relatives were selected. Fifty-four patients met these selection criteria: 29 having positive evidence of CAD and 25 with no evidence of disease. Multivariate analysis revealed that, after adjusting for age and gender, serum apoAI level was the only variable predictive of CAD. This effect was independent of HDL cholesterol level and fractional esterification rate of HDL (FERHDL). These results point to an important role for apoAI in the atherogenic process, particularly in populations with no major CAD risk factors. Decreased levels of apoAI or LpAI may initiate atherosclerosis in a highly selected group of low risk patients. (C) 2001 Elsevier Science Ireland Ltd. Al rights reserved.