Hepatology:小密度低密度脂蛋白胆固醇可以预测肝移植受者的心血管事件发生情况

2019-07-22 不详 MedSci原创

心血管疾病(CVD)是肝移植(LT)后发病率和死亡率的重要原因。尽管LT与血脂异常有关,特别是致动脉粥样硬化脂蛋白亚颗粒,但这些亚颗粒对CVD相关事件的影响尚不清楚。因此,本研究的目的是评估小密度(sdLDL-C)低密度脂蛋白(LDL)胆固醇(LDL-C)对CVD事件的影响。

背景及目的:
血管疾病(CVD)是肝移植(LT)后发病率和死亡率的重要原因。尽管LT与血脂异常有关,特别是致动脉粥样硬化脂蛋白亚颗粒,但这些亚颗粒对CVD相关事件的影响尚不清楚。因此,本研究的目的是评估小密度(sdLDL-C)低密度脂蛋白(LDL)胆固醇(LDL-C)对CVD事件的影响。

方法:
研究人员前瞻性纳入了130名患者,他们具有由传统脂质参数和sdLDL-C组成的详细脂质谱,并且进行随访观察CVD事件。主要终点是CVD事件,包括心肌梗死(MI),心绞痛,冠状动脉血运重建需要和心源性死亡。

结果:
该队列的平均年龄为58±11岁,发生肝病(LD)最常见的病因是丙型肝炎病毒(N = 48)和非酒精性脂肪性肝炎(N = 23)。在中位随访45个月后,共发现20例CVD事件。有和没有CVD事件的患者的基线传统概况相似。血清LDL-C截止值为100 mg / dL无法识别出有CVD事件风险的个体(P = 0.86)。相反,致动脉粥样硬化sdLDL-C> 25 mg / dL的血清浓度可预测CVD事件,风险比为6.376(95%置信区间,2.65,15.34; 86)。相反,致动脉粥样硬化sdLDL-C> 25 mg / dL的血清浓度可预测CVD事件,风险比为6.376(95%置信区间,2.65,15.34; 86)。致动脉粥样硬化sdLDL-C> 25 mg / dL的血清浓度可预测CVD事件,风险比为6.376(95%置信区间,2.65,15.34;P <0.001)。这种关系与糖尿病高血压,性别,种族,LD,肥胖和他汀类药物的使用无关。

结论
sdLDL-C独立预测CVD事件,而LDL-C则没有。因此,sdLDL-C可以提供LT后风险分层和管理患者的有用临床工具。

原始出处:

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    2019-07-24 gwc384
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    2019-07-23 phoebeyan520

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