Lipid profile and risk factors for neoatherosclerosis after drug-eluting stent implantation in acute coronary syndrome.

IF 3.6 3区医学 Q2 PHARMACOLOGY & PHARMACY Journal of clinical lipidology Pub Date : 2024-08-31 DOI:10.1016/j.jacl.2024.08.011

Norihito Nakamura, Katsuaki Sakai, Sho Torii, Yuki Aoki, Frederic Turcotte-Gosselin, Kazuki Fujinuma, Ami Ohwaki, Kazuki Aihara, Satoshi Noda, Junichi Miyamoto, Yu Sato, Manabu Shiozaki, Makoto Natsumeda, Yohei Ohno, Masataka Nakano, Fuminobu Yoshimachi, Gaku Nakazawa, Yuji Ikari

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Abstract

Background: Predictors of neoatherosclerosis in patients who received primary percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) remain unclear.

Objective: The aim of this study is to investigate the frequency and risk factors of neoatherosclerosis 1-year after the onset of ACS.

Methods: This study investigated 83 patients who underwent PCI for ACS followed by 1-year follow-up optical coherence tomography. The patients were categorized into the neoatherosclerosis (n = 11) and non-neoatherosclerosis groups (n = 72). Baseline characteristics, PCI procedures, medical therapies, and blood tests at 1-year, including detailed lipid profiles, were compared between the two groups.

Results: Diabetes mellitus was more prominent in the neoatherosclerosis than in the non-neoatherosclerosis group (45% vs. 17 %, respectively, p = 0.03). Total cholesterol (171 ± 37 mg/dL vs. 145 ± 25 mg/dL, respectively, p < 0.01), non-high-density lipoprotein cholesterol (HDL-C) (124 ± 36 mg/dL vs. 94 ± 24 mg/dL, respectively, p < 0.01), low-density lipoprotein cholesterol (94 ± 36 mg/dL vs. 72 ± 19 mg/dL, respectively, p < 0.01), and lipoprotein (a) (Lp[a]) (70 [19-112] mg/dL vs. 10 [3-25] mg/dL, respectively, p = 0.03) at follow-up were significantly higher in the neoatherosclerosis group. Multivariate analysis revealed that neoatherosclerosis was associated with high serum non-HDL-C (odds ratio [OR]: 1.075; 95 % confidence interval [CI]: 1.011-1.144; p < 0.01) and high serum Lp(a) levels (>30 mg/dL) (OR: 11.0; 95 % CI: 1.492-81.02; p = 0.02).

Conclusion: Poorly controlled non-HDL-C and Lp(a) would be risk factors of neoatherosclerosis in patients 1-year after ACS.

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急性冠状动脉综合征患者植入药物洗脱支架后的血脂状况和新动脉粥样硬化的风险因素。

背景：接受经皮冠状动脉介入治疗（PCI）的急性冠状动脉综合征（ACS）患者新动脉粥样硬化的预测因素尚不明确：接受初级经皮冠状动脉介入治疗（PCI）的急性冠状动脉综合征（ACS）患者出现新动脉粥样硬化的预测因素仍不明确：本研究旨在探讨急性冠状动脉综合征发病 1 年后新动脉粥样硬化的频率和风险因素：本研究调查了 83 名因 ACS 而接受 PCI 治疗的患者，并进行了为期 1 年的光学相干断层扫描随访。这些患者被分为新动脉粥样硬化组（n = 11）和非新动脉粥样硬化组（n = 72）。对两组患者的基线特征、PCI手术、药物治疗和1年后的血液检查（包括详细的血脂分析）进行了比较：结果：与非新动脉粥样硬化组相比，新动脉粥样硬化组的糖尿病发病率更高（分别为 45% 和 17%，P = 0.03）。总胆固醇（171 ± 37 mg/dL vs. 145 ± 25 mg/dL, 分别为 p < 0.01）、非高密度脂蛋白胆固醇（HDL-C）（124 ± 36 mg/dL vs. 94 ± 24 mg/dL, 分别为 p < 0.01）、低密度脂蛋白胆固醇（94 ± 36 mg/dL vs. 72 ± 19 mg/dL, 分别为 p < 0.01随访时，新动脉粥样硬化组的低密度脂蛋白胆固醇（94 ± 36 mg/dL vs. 94 ± 24 mg/dL，p < 0.01）、低密度脂蛋白胆固醇（72 ± 19 mg/dL，p < 0.01）和脂蛋白（a）（Lp[a]）（70 [19-112] mg/dL vs. 10 [3-25] mg/dL，p = 0.03）显著高于新动脉粥样硬化组。多变量分析显示，新动脉粥样硬化与高血清非高密度脂蛋白胆固醇有关（几率比 [OR]：1.075; 95 % 置信区间 [CI]：结论：结论：控制不佳的非高密度脂蛋白胆固醇和脂蛋白（a）将成为 ACS 一年后患者发生新动脉粥样硬化的危险因素。

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来源期刊

Journal of clinical lipidology 医学-药学

CiteScore

7.00

自引率

6.80%

发文量

209

审稿时长

49 days

期刊介绍： Because the scope of clinical lipidology is broad, the topics addressed by the Journal are equally diverse. Typical articles explore lipidology as it is practiced in the treatment setting, recent developments in pharmacological research, reports of treatment and trials, case studies, the impact of lifestyle modification, and similar academic material of interest to the practitioner. While preference is given to material of immediate practical concern, the science that underpins lipidology is forwarded by expert contributors so that evidence-based approaches to reducing cardiovascular and coronary heart disease can be made immediately available to our readers. Sections of the Journal will address pioneering studies and the clinicians who conduct them, case studies, ethical standards and conduct, professional guidance such as ATP and NCEP, editorial commentary, letters from readers, National Lipid Association (NLA) news and upcoming event information, as well as abstracts from the NLA annual scientific sessions and the scientific forums held by its chapters, when appropriate.