首次出现st段抬高型心肌梗死的青年和中年患者血清脂蛋白(a)水平的比较:一项单中心研究

IF 0.7 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Cardiovascular Journal of Africa Pub Date : 2023-08-25 DOI:10.5830/CVJA-2023-038

Songül Usalp, Emine Altuntaş, Bayram Bağırtan, Kanber Ö Karabay

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引用次数: 1

摘要

背景:脂蛋白(a) [Lp(a)]由于其致动脉粥样硬化和血栓形成的性质而与冠状动脉疾病有关。在这项研究中，我们旨在比较青年和中年st段抬高型心肌梗死(STEMI)患者的Lp(a)水平。方法:本回顾性研究纳入287例因STEMI首次就诊的20-65岁患者。患者分为两组:20 ~ 45岁(青年组，n = 111)和46 ~ 65岁(中年组，n = 176)。两组在人口学特征、合并症和实验室结果方面进行比较。结果:年轻组吸烟(99 89.2% vs 130 73.9%);P = 0.001)、冠心病家族史(75,67.6% vs 80,45.5;p < 0.001)，血清Lp(a)水平[38.1±27.9(93±68)vs 23.5±23.2 mg/dl(57±56 nmol/l)];P < 0.001]，甘油三酯水平[219.1±231.9(2.48±2.62)vs 170.2±105.6 mg/dl(1.92±1.19 mmol/l);P = 0.018)，射血分数(52.4±6.1 vs 47.2±7.7%;P = 0.004)和单血管疾病(83,74.8% vs 110 62.5%;P = 0.031)高于中老年组。在多变量logistic回归分析中，家族史(OR: 2.073, 95% CI: 1.210-3.549;p = 0.008)，低高密度脂蛋白胆固醇水平(OR: 1.032, 95% CI: 1.003-1.062;p = 0.029)和Lp(a)升高(OR: 1.981, 95% CI: 1.871-3.991;p < 0.001)是年轻STEMI患者可能的独立危险因素。结论:与中年患者组相比，首次出现STEMI的年轻患者Lp(a)水平更高，可能是一个独立的危险因素。Lp(a)是一种高度致动脉粥样硬化分子，它与中风、心力衰竭、主动脉狭窄以及冠状动脉疾病有关。在心血管疾病高风险的年轻患者中，可能推荐测量Lp(a)水平。

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Comparison of serum lipoprotein(a) levels in young and middle-aged patients presenting for the first time with ST-elevation myocardial infarction: a single-centre study.

Background: Lipoprotein(a) [Lp(a) ] is associated with coronary artery disease due to its atherogenic and thrombogenic nature. In this study, we aimed to compare the level of Lp(a) in young and middle-aged patients with ST-elevation myocardial infarction (STEMI).

Methods: This retrospective study included 287 patients aged 20-65 years who presented to the emergency department for the first time due to STEMI. The patients were divided into two groups: 20-45 years (young group, n = 111) and 46-65 years (middle-aged group, n = 176). The groups were compared in terms of demographic characteristics, co-morbidities and laboratory findings.

Results: In the young group, smoking (99, 89.2% vs 130, 73.9%; p = 0.001), family history of coronary artery disease (75, 67.6% vs 80, 45.5; p < 0.001), serum Lp(a) level [38.1 ± 27.9 (93 ± 68) vs 23.5 ± 23.2 mg/dl (57 ± 56 nmol/l); p < 0.001], triglyceride level [219.1 ± 231.9 (2.48 ± 2.62) vs 170.2 ± 105.6 mg/dl (1.92 ± 1.19 mmol/l); p = 0.018), ejection fraction (52.4 ± 6.1 vs 47.2 ± 7.7%; p = 0.004) and single-vessel disease (83, 74.8% vs 110, 62.5%; p = 0.031) were higher than in the middle-aged group. In multivariable logistic regression analyses, family history (OR: 2.073, 95% CI: 1.210-3.549; p = 0.008), low high-density lipoprotin cholesterol level (OR: 1.032, 95% CI: 1.003-1.062; p = 0.029) and Lp(a) elevation (OR: 1.981, 95% CI: 1.871-3.991; p < 0.001) were possible independent risk factors for STEMI in young patients.

Conclusion: Lp(a) level was found to be a higher and a possible independent risk factor in young patients who presented with STEMI for the first time, compared to the middle-aged patient group. Lp(a) is a highly atherogenic molecule and it has been associated with stroke, heart failure, aortic stenosis, as well as coronary artery disease. Measurement of Lp(a) levels may be recommended in young patients with high cardiovascular risk.

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来源期刊

Cardiovascular Journal of Africa CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： The Cardiovascular Journal of Africa (CVJA) is an international peer-reviewed journal that keeps cardiologists up to date with advances in the diagnosis and treatment of cardiovascular disease. Topics covered include coronary disease, electrophysiology, valve disease, imaging techniques, congenital heart disease (fetal, paediatric and adult), heart failure, surgery, and basic science.