Free fatty acids are independently associated with all-cause and cardiovascular mortality in subjects with coronary artery disease
Free fatty acids are independently associated with all-cause and cardiovascular mortality in subjects with coronary artery disease
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DOI：
10.1210/jc.2006-0195
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发表时间：
2006-07-01
影响因子：
5.8
通讯作者：
Maerz, Winfried
中科院分区：
文献类型：
--
作者：
Pilz, Stefan;Scharnagl, Hubert;Maerz, Winfried
背景：游离脂肪酸 (FFA) 与多种心血管危险因素相关，并对心肌产生有害影响。目的：我们研究的目的是阐明 FFA 与接受冠状动脉造影的受试者死亡率之间的关系。设计、设置和参与者：路德维希港风险与心血管健康是一项针对基线时（1997-2000 年）接受冠状动脉造影的白种人的前瞻性队列研究。在 5.38 年的中位随访时间内，测量了 FFA 的 3315 名研究参与者中发生了 513 例死亡。主要结果测量：根据 FFA 水平测量了死亡风险比。结果：在 FFA 的第四个四分位处，全因死亡和心血管原因死亡的完全调整风险比分别为 1.58（P = 0.002）和 1.83（P = 0.001），分别。在患有血管造影冠状动脉疾病 (CAD)、稳定性 CAD 和不稳定 CAD 的患者中，FFA 的预测值与整个队列中的预测值相似，但在单独分析的非 CAD 患者中，这种关联并未达到统计学显着性。 FFA 水平与血管造影 CAD 的存在无关，但与稳定 CAD 的先证者相比，不稳定 CAD 受试者的 FFA 水平升高。此外，FFA 随着心力衰竭的严重程度而增加，并且与 N 末端 B 型利钠肽原呈正相关（P < 0.001）。结论：FFA 水平独立预测血管造影 CAD 受试者的全因死亡率和心血管死亡率。 FFA 可能的诊断用途值得进一步研究，但我们的结果可能强调影响 FFA 代谢的治疗方法的重要性。
Context: Free fatty acids (FFAs) are associated with several cardiovascular risk factors and exert harmful effects on the myocardium.Objective: The aim of our study was to elucidate the relationship between FFAs and mortality in subjects who underwent coronary angiography.Design, Setting, and Participants: Ludwigshafen Risk and Cardiovascular Health is a prospective cohort study of Caucasians who had undergone coronary angiography at baseline (1997-2000). During a median time of follow-up of 5.38 yr, 513 deaths had occurred among 3315 study participants with measured FFAs.Main Outcome Measure: Hazard ratios for mortality according to FFA levels were measured.Results: At the fourth quartile of FFAs, fully adjusted hazard ratios for death from any cause and cardiovascular causes were 1.58 (P = 0.002) and 1.83 (P = 0.001), respectively. In persons with angio-graphic coronary artery disease (CAD), stable CAD, and unstable CAD, the predictive value of FFAs was similar to that in the entire cohort, but the association did not attain statistical significance in persons without CAD analyzed separately. FFA levels were not related to the presence of angiographic CAD but were elevated in subjects with unstable CAD, compared with probands with stable CAD. Furthermore, FFAs increased with the severity of heart failure and were positively correlated with N-terminal pro-B-type natriuretic peptide (P < 0.001).Conclusions: FFA levels independently predict all-cause and cardiovascular mortality in subjects with angiographic CAD. A possible diagnostic use of FFAs warrants further studies, but our results may underline the importance of therapeutic approaches to influence FFA metabolism.