Acute versus Chronic Myocardial Ischemia: A Differential Biological Profile Study
Acute versus Chronic Myocardial Ischemia: A Differential Biological Profile Study
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DOI：
10.1159/000173728
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发表时间：
2007-01-01
影响因子：
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通讯作者：
Antonio Iriarte, Jose
中科院分区：
文献类型：
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作者：
Domingo Sagastagoitia, Jose;Saez, Yolanda;Antonio Iriarte, Jose
目的：确定脂质、血栓形成和炎症标志物浓度以及慢性和急性冠状动脉疾病（分别为稳定型和不稳定型心绞痛）存在的可能差异，并将其与一组冠状动脉正常的对照组进行比较。材料和方法：本前瞻性队列研究纳入125例不稳定型心绞痛患者，189例稳定型心绞痛患者和83例冠状动脉正常的对照组患者。3组均测定标记物浓度。通过Logistic回归分析确定这些因素是否可以预测不稳定型或稳定型心绞痛。结果：两组冠心病患者血脂参数浓度相近，且明显低于对照组。冠状动脉疾病患者的止血和炎症标志物浓度较高，但只有在将不稳定型心绞痛患者与正常对照进行比较时才有统计学意义。不稳定型心绞痛患者的脂蛋白(a) [Lp(a)]、纤维蛋白原、c反应蛋白（CRP）和白细胞水平明显升高。多因素logistic回归分析显示，CRP （OR 2.635, 95% CI 1.417-4.898）、吸烟（OR 3.416, 95% CI 1.773-6.584）、白细胞（OR 2.034, 95% CI 1.079-3.836）和Lp(a) （OR 2.269, 95% CI 1.188-4.334）是不稳定型与稳定型心绞痛的独立危险因素。结论：不稳定型心绞痛患者比稳定型心绞痛患者更容易发生动脉粥样硬化。与吸烟一起，增高的Lp(a)、CRP和白细胞浓度被证明与不稳定型心绞痛的存在有关。版权所有(C) 2009 S. Karger AG，巴塞尔
Objective: To determine the possible differences in lipid, thrombogenic and inflammatory marker concentrations and the presence of chronic and acute coronary artery disease ( stable and unstable angina, respectively), comparing them with a group of control patients with normal coronary arteries. Material and Methods: This prospective cohort study included 125 patients with unstable angina, 189 with stable angina and a control group of 83 patients with normal coronary arteries. Marker concentrations were measured in all 3 groups. Logistic regression analysis was performed to determine whether such factors could predict unstable or stable angina. Results: Lipid parameter concentrations were similar in the 2 coronary disease groups and significantly lower than in controls. Haemostatic and inflammatory marker concentrations were higher in patients with coronary disease, but were statistically significant only when comparing unstable angina patients with normal controls. Unstable angina patients had significantly higher levels of lipoprotein ( a) [Lp(a)], fibrinogen, C-reactive protein (CRP) and leucocytes. Multiple logistic regression analysis showed that CRP (OR 2.635, 95% CI 1.417-4.898), smoking ( OR 3.416, 95% CI 1.773-6.584), leucocytes ( OR 2.034, 95% CI 1.079-3.836) and Lp(a) ( OR 2.269, 95% CI 1.188-4.334) were independent risk factors of unstable versus stable angina. Conclusions: Patients with unstable angina present a more atherogenic profile than patients with stable angina. Together with smoking, elevated Lp( a), CRP and leucocyte concentrations proved to be associated with the presence of unstable angina. Copyright (C) 2009 S. Karger AG, Basel