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Abstract：
BACKGROUND: High-density lipoprotein cholesterol (HDL-C) is shown to be an independent protective factor against coronary artery diseases (CAD). Yet there are limited studies focusing on the association between HDL-C and coronary artery bypass graft (CABG) surgery outcomes.
OBJECTIVE: Low levels of HDL-C are associated with higher incidence of adverse outcomes in patients undergoing CABG.
METHODS: This registry-based study included 17,772 patients who underwent elective isolated CABG between 2007 and 2017. Patients were classified into low and desirable HDL-C groups based on their serum HDL-C levels at admission and were followed for one-year post-surgery. The study population included 13,321 patients with low HDL-C and 4,451 with desirable HDL-C. proportional hazard Cox models were performed to evaluate the association between HDL-C levels and incidence of mortality as well as major adverse cardiovascular and cerebrovascular events (MACCE), while adjusting for potential confounders. Moreover, participants were stratified based on sex and the association was also investigated in each subgroup separately.
RESULTS: No significant difference was found between the groups regarding incidence of both mortality and MACCE, after adjusting with Inverse Probability Weighting (IPW) [HR (95%CI): 0.84 (0.46-1.53), p-value:0.575 and HR (95% CI): 0.91 (0.56-1.50), p-value:0.733, respectively]. According to the sex-based subgroup analysis, no significant association was observed after adjustment with IPW analysis. However, as we examined the association between the interaction of HDL-C levels, sex and cardiovascular outcomes, we found a significant association (HR;1.19 (95%CI: 1.04-1.45); p = 0.030).
CONCLUSIONS: HDL-C level was not associated with either mortality or MACCE during one year after CABG procedure. Sex-based analysis showed that in males, HDL-C is significantly more protective against these outcomes, compared to females. Further studies are necessary to elucidate the exact mechanisms mediating such association.
OBJECTIVE: Low levels of HDL-C are associated with higher incidence of adverse outcomes in patients undergoing CABG.
METHODS: This registry-based study included 17,772 patients who underwent elective isolated CABG between 2007 and 2017. Patients were classified into low and desirable HDL-C groups based on their serum HDL-C levels at admission and were followed for one-year post-surgery. The study population included 13,321 patients with low HDL-C and 4,451 with desirable HDL-C. proportional hazard Cox models were performed to evaluate the association between HDL-C levels and incidence of mortality as well as major adverse cardiovascular and cerebrovascular events (MACCE), while adjusting for potential confounders. Moreover, participants were stratified based on sex and the association was also investigated in each subgroup separately.
RESULTS: No significant difference was found between the groups regarding incidence of both mortality and MACCE, after adjusting with Inverse Probability Weighting (IPW) [HR (95%CI): 0.84 (0.46-1.53), p-value:0.575 and HR (95% CI): 0.91 (0.56-1.50), p-value:0.733, respectively]. According to the sex-based subgroup analysis, no significant association was observed after adjustment with IPW analysis. However, as we examined the association between the interaction of HDL-C levels, sex and cardiovascular outcomes, we found a significant association (HR;1.19 (95%CI: 1.04-1.45); p = 0.030).
CONCLUSIONS: HDL-C level was not associated with either mortality or MACCE during one year after CABG procedure. Sex-based analysis showed that in males, HDL-C is significantly more protective against these outcomes, compared to females. Further studies are necessary to elucidate the exact mechanisms mediating such association.
摘要：
背景：高密度脂蛋白胆固醇（HDL-C）被证明是对抗冠状动脉疾病（CAD）的独立保护因素。然而，只有有限的研究集中在HDL-C和冠状动脉旁路移植术（CABG）手术结果之间的关联。
目的：低HDL-C水平与CABG患者不良结局的发生率相关。
方法：这项基于注册表的研究包括2007年至2017年期间接受选择性隔离CABG的17,772例患者。根据入院时的血清HDL-C水平将患者分为低HDL-C组和理想HDL-C组，并在手术后随访一年。研究人群包括13,321名低HDL-C患者和4,451名具有所需HDL-C的患者。使用比例风险Cox模型评估HDL-C水平与死亡率以及主要不良心血管和脑血管事件(MACCE)之间的关系,同时调整潜在的混杂因素。此外，根据性别对参与者进行分层,并在每个亚组中分别调查相关性.
结果：在死亡率和MACCE的发生率方面，两组之间没有发现显着差异，用逆概率加权(IPW)调整后[HR(95CI)：0.84(0.46-1.53)，p值：0.575和HR（95%CI）：0.91（0.56-1.50），p值：分别为0.733]。根据基于性别的亚组分析，经IPW分析校正后,未观察到显著关联.然而,当我们检查HDL-C水平的相互作用之间的关联时，性和心血管结果，我们发现了显著的相关性(HR;1.19(95CI:1.04-1.45);p=0.030).
结论：在CABG手术后一年内，HDL-C水平与死亡率或MACCE无关。基于性别的分析表明，在男性中，HDL-C对这些结果的保护作用明显更强，与女性相比。需要进一步的研究来阐明介导这种关联的确切机制。
目的：低HDL-C水平与CABG患者不良结局的发生率相关。
方法：这项基于注册表的研究包括2007年至2017年期间接受选择性隔离CABG的17,772例患者。根据入院时的血清HDL-C水平将患者分为低HDL-C组和理想HDL-C组，并在手术后随访一年。研究人群包括13,321名低HDL-C患者和4,451名具有所需HDL-C的患者。使用比例风险Cox模型评估HDL-C水平与死亡率以及主要不良心血管和脑血管事件(MACCE)之间的关系,同时调整潜在的混杂因素。此外，根据性别对参与者进行分层,并在每个亚组中分别调查相关性.
结果：在死亡率和MACCE的发生率方面，两组之间没有发现显着差异，用逆概率加权(IPW)调整后[HR(95CI)：0.84(0.46-1.53)，p值：0.575和HR（95%CI）：0.91（0.56-1.50），p值：分别为0.733]。根据基于性别的亚组分析，经IPW分析校正后,未观察到显著关联.然而,当我们检查HDL-C水平的相互作用之间的关联时，性和心血管结果，我们发现了显著的相关性(HR;1.19(95CI:1.04-1.45);p=0.030).
结论：在CABG手术后一年内，HDL-C水平与死亡率或MACCE无关。基于性别的分析表明，在男性中，HDL-C对这些结果的保护作用明显更强，与女性相比。需要进一步的研究来阐明介导这种关联的确切机制。
