PDF(Pubmed)
Abstract：
OBJECTIVE: This study aimed to investigate the association between a combination of elevated triglyceride (TG) and reduced high-density lipoprotein cholesterol (HDL-C) levels and target lesion revascularization (TLR) following everolimus-eluting stent (EES) implantation. The adverse impact of clinical, lesion, and procedural characteristics on TLR in patients with elevated TG and reduced HDL-C levels was also assessed.
METHODS: We retrospectively collected data on 3,014 lesions from 2,022 consecutive patients, who underwent EES implantation at Koto Memorial Hospital. Atherogenic dyslipidemia (AD) is defined as a combination of non-fasting serum TG ≥ 175 mg/dL and HDL-C ＜40 mg/dL.
RESULTS: AD was observed in 212 lesions in 139 (6.9%) patients. The cumulative incidence of clinically driven TLR was significantly higher in patients with AD than in those without AD (hazard ratio [HR] 2.31, 95% confidence interval [CI] 1.43-3.73, P=0.0006). Subgroup analysis showed that AD increased the risk of TLR with the implantation of small stents (≤ 2.75 mm). Multivariable Cox regression analysis showed that AD was an independent predictor of TLR in the small EES stratum (adjusted HR 3.00, 95% CI 1.53-5.93, P=0.004), whereas the incidence of TLR was similar in the non-small-EES stratum, irrespective of the presence or absence of AD.
CONCLUSIONS: Patients with AD had a higher risk of TLR after EES implantation, and this risk was greater for lesions treated with small stents.
METHODS: We retrospectively collected data on 3,014 lesions from 2,022 consecutive patients, who underwent EES implantation at Koto Memorial Hospital. Atherogenic dyslipidemia (AD) is defined as a combination of non-fasting serum TG ≥ 175 mg/dL and HDL-C ＜40 mg/dL.
RESULTS: AD was observed in 212 lesions in 139 (6.9%) patients. The cumulative incidence of clinically driven TLR was significantly higher in patients with AD than in those without AD (hazard ratio [HR] 2.31, 95% confidence interval [CI] 1.43-3.73, P=0.0006). Subgroup analysis showed that AD increased the risk of TLR with the implantation of small stents (≤ 2.75 mm). Multivariable Cox regression analysis showed that AD was an independent predictor of TLR in the small EES stratum (adjusted HR 3.00, 95% CI 1.53-5.93, P=0.004), whereas the incidence of TLR was similar in the non-small-EES stratum, irrespective of the presence or absence of AD.
CONCLUSIONS: Patients with AD had a higher risk of TLR after EES implantation, and this risk was greater for lesions treated with small stents.
摘要：
目的：本研究旨在探讨依维莫司洗脱支架（EES）植入后甘油三酯（TG）升高和高密度脂蛋白胆固醇（HDL-C）水平降低与靶病变血运重建（TLR）之间的关系。临床的不利影响，病变,同时还评估了TG升高和HDL-C降低的患者TLR的程序特征.
方法：我们回顾性收集了2,022例连续患者的3,014个病灶的数据，他在Koto纪念医院接受了EES植入。动脉粥样硬化血脂异常（AD）定义为非空腹血清TG≥175mg/dL和HDL-C＜40mg/dL。
结果：在139例（6.9％）患者的212个病灶中观察到AD。AD患者临床驱动的TLR的累积发生率明显高于无AD患者（风险比[HR]2.31，95％置信区间[CI]1.43-3.73，P=0.0006）。亚组分析显示，AD随着小支架（≤2.75mm）的植入而增加TLR的风险。多变量Cox回归分析显示AD是小EES层TLR的独立预测因子(校正HR3.00,95%CI1.53~5.93,P=0.004),而TLR在非小EES层的发生率相似，无论是否存在AD。
结论：AD患者在EES植入后发生TLR的风险更高，对于小支架治疗的病变，这种风险更大。
方法：我们回顾性收集了2,022例连续患者的3,014个病灶的数据，他在Koto纪念医院接受了EES植入。动脉粥样硬化血脂异常（AD）定义为非空腹血清TG≥175mg/dL和HDL-C＜40mg/dL。
结果：在139例（6.9％）患者的212个病灶中观察到AD。AD患者临床驱动的TLR的累积发生率明显高于无AD患者（风险比[HR]2.31，95％置信区间[CI]1.43-3.73，P=0.0006）。亚组分析显示，AD随着小支架（≤2.75mm）的植入而增加TLR的风险。多变量Cox回归分析显示AD是小EES层TLR的独立预测因子(校正HR3.00,95%CI1.53~5.93,P=0.004),而TLR在非小EES层的发生率相似，无论是否存在AD。
结论：AD患者在EES植入后发生TLR的风险更高，对于小支架治疗的病变，这种风险更大。
