Elevated plasma free fatty acids predict sudden cardiac death:: a 6.85-year follow-up of 3315 patients after coronary angiography
Elevated plasma free fatty acids predict sudden cardiac death:: a 6.85-year follow-up of 3315 patients after coronary angiography
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DOI：
10.1093/eurheartj/ehm343
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发表时间：
2007-11-01
影响因子：
39.3
通讯作者：
Maerz, Winfried
中科院分区：
文献类型：
--
作者：
Pilz, Stefan;Scharnagl, Hubert;Maerz, Winfried
目的心源性猝死（SCD）是最常见的致命心血管事件。游离脂肪酸（FFA）对心肌产生多种有害影响，因此可能导致SCD。我们研究了空腹FFA是否预测SCD的患者谁经历了coronary angiography.Methods和结果FFA测量基线（1997-2000）在3315例患者预定进行冠状动脉造影。在2231名研究参与者中发现了血管造影冠状动脉疾病。在中位随访时间为6.85年后，整个研究人群中发生了165例SCD。在考克斯比例风险模型中，与FFA第一四分位数相比，第四个四分位数中SCD的未校正风险比（HR）为2.95（95% CI 1.84-4.73; P < 0.001）。校正常见和新出现的心血管危险因素后，HR仍显著为1.76（1.03-3.00; P = 0.038）。高FFA水平也显着相关的全因和心血管死亡率，即使排除后的患者与SCD。结论我们的研究表明，血浆FFA升高是一个独立的危险因素，为未来SCD的患者提到冠状动脉造影。这些结果可能表明，心肌脂肪酸摄取和/或代谢的调制是一个可能的治疗目标，但它仍然有待澄清是否高FFA水平是FFA和SCD之间的关联的病理过程的原因或结果。
Aims Sudden cardiac death (SCD) is the most common fatal cardiovascular event. Free fatty acids (FFAs) exert several harmful effects on the myocardium and may therefore contribute to SCD. We examined whether fasting FFA predict SCD in patients who had undergone coronary angiography.Methods and results FFAs were measured at baseline (1997-2000) in 3315 patients scheduled for coronary angiography. Angiographic coronary artery disease was found in 2231 study participants. After a median time of follow-up of 6.85 years, 165 SCD occurred in the entire study population. In a Cox proportional hazards model, the unadjusted hazard ratio (HR) for SCD in the fourth when compared with the first FFA quartile was 2.95 (95% CI 1.84-4.73; P < 0.001). After adjustment for common and emerging cardiovascular risk factors, the HR remained significant at 1.76 (1.03-3.00; P = 0.038). High FFA levels were also significantly associated with all-cause and cardiovascular mortality, even after exclusion of patients with SCD.Conclusion Our study shows that elevated plasma FFAs are an independent risk factor for future SCD in patients referred to coronary angiography. These results may suggest that modulation of myocardial fatty acid uptake and/ or metabolism are a possible target of treatment, but it still remains to be clarified whether high FFA levels are a cause or a consequence of pathological processes that underlie the association between FFA and SCD.