JAHA:血清中酰基肉毒碱与稳定型心绞痛患者心血管死亡和急性心肌梗死之间风险评估!

2017-02-13 xing.T MedSci原创

在疑似冠心病稳定型心绞痛的患者中,血清中升高的双链酰基肉毒碱与心血管疾病死亡的风险增加相关,而与急性心肌梗死在较小的程度上相关,并且独立于传统的危险因素。

血清中过多的酰基肉毒碱,它是代谢过程中的中间产物,已在代谢性疾病如2型糖尿病被观察到。然而,到目前为止,尚不知道血清中的酰基肉毒碱可否前瞻性地预测性稳定型心绞痛患者心血管死亡或急性心肌梗死的风险。近日,心血管疾病领域权威杂志JAHA上针对这一问题发表了一篇研究文章。

该研究共纳入了4164例患者(平均年龄为62岁,男性占72%)。研究人员通过采用液相色谱/串联质谱检测了这些参与者血清中基础的乙酰-、辛-、棕榈酰-、丙-、以及(异)戊酰肉碱水平,并报告了第4四分位数范围内患者比上第1四分位数范围内患者的风险比和95%可信区间。多变量模型中包括的变量有年龄、性别、体重指数、空腹状态、当前吸烟、糖尿病、载脂蛋白A1、载脂蛋白B、肌酐、左室射血分数、冠状动脉疾病程度、研究中心和叶酸或维生素B6干预。

在平均进行10.2年的后续随访中,10.0%的患者死于心血管疾病,12.8%的患者遭受致命或非致命性急性心肌梗死。较高水平的双链乙酰-、辛-和棕榈酰-肉碱与心血管死亡风险升高显著相关,经过多变量调整后仍然存在(风险比[95%可信区间]分别为1.52 [1.12,2.06],P=0.007;1.73[1.23,2.44],P=0.002;1.61[1.18,2.21],P=0.003),然而其与急性心肌梗死的相关性则并不一致。

在疑似冠心病稳定型心绞痛的患者中,血清中升高的双链酰基肉毒碱与心血管疾病死亡的风险增加相关,而与急性心肌梗死在较小的程度上相关,并且独立于传统的危险因素。

原始出处:

Elin Strand,et al. Serum Acylcarnitines and Risk of Cardiovascular Death and Acute Myocardial Infarction in Patients With Stable Angina Pectoris. JAHA.2017. https://doi.org/10.1161/JAHA.116.003620

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