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Predictive effect of apolipoprotein A1 on major adverse cardiovascular events in patients with unstable angina pectoris

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Author:: No author available

Journal Title:: China Medicine

Issue:: 2

DOI:: 10.3760/j.issn.1673-4777.2023.02.003

Key Word:: 不稳定型心绞痛;载脂蛋白A1;主要不良心血管事件

Abstract：目的探讨载脂蛋白A1(ApoA1)对不稳定型心绞痛(UAP)患者主要不良心血管事件(MACE)的预测作用.方法连续选取2016 年12 月1 日至2019 年12 月15 日于新疆医科大学第一附属医院心脏中心确诊为UAP的住院患者.收集患者年龄、性别、血常规、空腹血糖、血脂等基线资料.所有患者出院后持续随访48 个月,根据MACE发生与否将患者分为MACE组和非MACE组.分析ApoA1 对UAP患者发生MACE的预测作用.结果本研究共纳入UAP患者333 例,MACE组136 例,非MACE组197 例.MACE组男性、高血压病、糖尿病、肥胖比例、血小板计数、三酰甘油水平均高于非 MACE组,ApoA1 水平低于非 MACE组[(1.11±0.22)g/L比(1.28±0.41)g/L],差异均有统计学意义(均P<0.05).多因素Cox回归分析结果显示,ApoA1 是UAP患者发生MACE的独立保护因素(P<0.05).受试者工作特征曲线分析结果显示,ApoA1 预测UAP患者发生MACE的曲线下面积为0.631(95%置信区间:0.572~0.691,P<0.001),截断值为1.16 g/L,敏感度为 81%,特异度为 59%.根据ApoA1 截断值将 333 例患者分为低ApoA1 组(ApoA1≤1.16 g/L,168 例)和高 ApoA1 组(ApoA1>1.16 g/L,165 例).Kaplan-Meier 生存曲线分析结果显示,低ApoA1 组累积生存率明显低于高 ApoA1 组,差异有统计学意义(Log-rank P = 0.018).结论 ApoA1 对UAP患者MACE有一定的预测价值.

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