Stroke:载脂蛋白CIII升高的心血管患者缺血性脑血管事件发生率增加

2019-12-04 xing.T MedSci原创

该研究的结果表明,血浆高浓度Apo CIII可能预示心血管患者发生缺血性卒中/TIA的风险增加。

载脂蛋白CIII(Apo CIII)是脂蛋白代谢的关键调节因子,与凝血因子活性和凝血酶生成增加有关,进而与动静脉血栓栓塞事件的风险增加有关。近日,心血管疾病领域权威杂志Stroke上发表了一篇研究文章,研究人员假设这可能会影响心血管患者的急性缺血性脑血管事件的风险。

研究人员对950名伴有或没有血管造影确定的冠状动脉疾病(CAD:分别为774 CAD患者和176名无CAD患者)的受试者(中位年龄为65岁,四分位间距为55-79岁,30.7%的女性)病历进行了系统地评估,并量化了脑缺血事件。研究人员对1999年5月至2006年12月之间所有招募的受试者进行前瞻性随访,直到死亡或2018年7月31日为止。入选时所有受试者均评估了完整的血脂和载脂蛋白谱,包括Apo AI、B、CIII和E。

在中位随访130个月(四分位间距为69-189)后,95名受试者(10%)发生了缺血性卒中/短暂性脑缺血发作(TIA)事件。卒中/TIA受试者入组时的Apo CIII血浆浓度(11.4;四分位数范围:9.3-14.4 mg/dL)高于没有卒中/TIA的受试者(10.4,四分位数范围:8.7-13.0 mg/dL)。即使调整了潜在的混杂因素,包括性别、年龄、CAD诊断高血压房颤、口服抗凝剂治疗和所有血浆脂质参数,Apo CIII水平高于均值(10.6 mg/dL)的受试者也显示出卒中/TIA风险增加了约2倍(风险比为2.23[95%CI为1.21-4.13])。该结果已分别在CAD和无CAD人群中得到证实,甚至通过倾向评分匹配方法得到了证实,其中98名CAD患者和98名无CAD受试者在所有临床和实验室特征上都是一对一匹配的。

该研究的结果表明,血浆高浓度Apo CIII可能预示心血管患者发生缺血性卒中/TIA的风险增加。 

原始出处:

Oliviero Olivieri.et al.Increased Incidence of Ischemic Cerebrovascular Events in Cardiovascular Patients With Elevated Apolipoprotein CIII.stroke.2019.https://www.ahajournals.org/doi/10.1161/STROKEAHA.119.026811

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  5. 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  6. 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  7. 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