目的:我们研究了外周动脉疾病(PAD)患者血浆二十碳五烯酸(EPA)水平与长期全因死亡(ACD)和心血管或肢体事件之间的关系。方法:我们对637例PAD患者进行了前瞻性队列研究。终点是ACD,主要不良心血管事件(MACE),和下肢动脉事件(LEAE)。结果:ACD的发生率,MACEs,LEAE与EPA水平相关(p<0.05)。血浆EPA水平与高密度脂蛋白胆固醇呈显著正相关,甘油三酯,和估计的肾小球滤过率(eGFR),与C反应蛋白(CRP)呈负相关。在Cox逐步多变量分析中,较低的EPA(危险比[HR]:0.996,95%置信区间[CI]:0.993-1.000,p=0.034),踝臂压指数(ABI),身体质量指数,血清白蛋白,eGFR,年龄,CRP,D-二聚体,严重肢体缺血,糖尿病,脑血管疾病(CVD),和他汀类药物与ACD相关(p<0.05);较低的EPA(HR:0.997,95%CI:0.994-1.000,p=0.038),ABI,血清白蛋白,eGFR,年龄,糖尿病,冠心病,CVD,和他汀类药物与MACEs相关(p<0.05);较低的EPA(HR:0.988,95%CI:0.982-0.993,p<0.001),ABI,低密度脂蛋白胆固醇与LEAEs相关(p<0.05)。结论:低血浆EPA水平是ACD的重要危险因素,MACEs,PAD患者的LEAE。
Objectives: We examined the relationship between plasma eicosapentaenoic acid (EPA) level and long-term all-cause death (ACD) and cardiovascular or limb events in patients with peripheral arterial disease (PAD). Method: We performed a prospective cohort study on 637 PAD patients. The endpoints were ACD, major adverse cardiovascular events (MACEs), and lower extremity arterial events (LEAEs). Results: The incidences of ACD, MACEs, and LEAEs had correlation with EPA levels (p <0.05). Plasma EPA level had significant positive correlations with high-density lipoprotein cholesterol, triglyceride, and estimated glomerular filtration rate (eGFR), and negative correlation with C-reactive protein (CRP). In Cox stepwise multivariate analysis, lower EPA (hazard ratio [HR]: 0.996, 95% confidence interval [CI]: 0.993-1.000, p = 0.034), ankle brachial pressure index (ABI), body mass index, serum albumin, eGFR, age, CRP, D-dimer, critical limb ischemia, diabetes, cerebrovascular disease (CVD), and statin were related to ACD (p <0.05); lower EPA (HR: 0.997, 95% CI: 0.994-1.000, p = 0.038), ABI, serum albumin, eGFR, age, diabetes, coronary heart disease, CVD, and statin were related to MACEs (p <0.05); and lower EPA (HR: 0.988, 95% CI: 0.982-0.993, p <0.001), ABI, and low-density lipoprotein cholesterol were related to LEAEs (p <0.05). Conclusions: Low plasma EPA level was a significant risk factor for ACD, MACEs, and LEAEs in patients with PAD.