Plasma concentrations of molecular lipid species predict long-term clinical outcome in coronary artery disease patients
Plasma concentrations of molecular lipid species predict long-term clinical outcome in coronary artery disease patients
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DOI：
10.1194/jlr.p081281
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发表时间：
2018-09-01
影响因子：
6.5
通讯作者：
Kardys, Isabella
中科院分区：
文献类型：
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作者：
Anroedh, Sharda;Hilvo, Mika;Kardys, Isabella
我们在冠状动脉疾病 (CAD) 患者中位随访 4.7 年期间，研究了 10 种先前确定的高风险分子脂质种类和三种神经酰胺比率与主要不良心脏事件 (MACE) 发生的关联。 2008年至2011年间，581名患者因稳定型心绞痛（SAP）或急性冠状动脉综合征（ACS）接受了诊断性冠状动脉造影或经皮冠状动脉介入治疗。在索引程序之前抽血并测定脂质种类。主要终点是 MACE 的发生，包括全因死亡率、非致命性 ACS 或计划外冠状动脉血运重建。次要终点包括全因死亡率或非致命性 ACS。在中位随访 4.7 [IQR：4.2-5.6] 年期间，155 名患者 (27%) 出现 MACE。在多变量分析中，Cer(d18:1/16:0) 浓度与 MACE 相关{风险比 2.32；调整心脏危险因素、临床表现、基线时他汀类药物的使用以及入院非 HDL 胆固醇水平后，自然对数 (ln) (pmol/ml) P = 0.030} 的 95% CI [1.09-4.96]。此外，经过多变量调整后，Cer(d18:1/16:0)、Cer(d18:1/20:0)、Cer(d18:1/24:1)的浓度及其与Cer(d18:1/24:0)的比率与复合终点死亡或非致命性ACS相关。这些数据共同表明，我们在此研究的循环神经酰胺脂质与长期随访期间的不良心脏结果相关，与临床危险因素无关。
We investigated the associations of ten previously identified high risk molecular lipid species and three ceramide ratios with the occurrence of major adverse cardiac events (MACEs) during a median follow-up of 4.7 years in patients with coronary artery disease (CAD). Between 2008 and 2011, 581 patients underwent diagnostic coronary angiography or percutaneous coronary intervention for stable angina pectoris (SAP) or acute coronary syndrome (ACS). Blood was drawn prior to the index procedure and lipid species were determined. The primary endpoint was the occurrence of a MACE, comprising all-cause mortality, nonfatal ACS, or unplanned coronary revascularization. The secondary endpoint comprised all-cause mortality or nonfatal ACS. During a median follow-up of 4.7 [IQR: 4.2-5.6] years, 155 patients (27%) had MACEs. In multivariable analyses, Cer(d18:1/16:0) concentration was associated with MACEs {hazard ratio 2.32; 95% CI [1.09-4.96] per natural logarithm (ln) (pmol/ml) P = 0.030} after adjustment for cardiac risk factors, clinical presentation, statin use at baseline, and admission nonHDL cholesterol level. Furthermore, after multivariable adjustment, concentrations of Cer(d18:1/16:0), Cer(d18:1/20:0), Cer(d18:1/24:1), and their ratios to Cer(d18:1/24:0) were associated with the composite endpoint death or nonfatal ACS. The data together show the circulating ceramide lipids we investigated here are associated with adverse cardiac outcome during long-term follow-up independent of clinical risk factors.