研究报道

残粒胆固醇、同型半胱氨酸预测老年急性心肌梗死患者新发心房颤动的价值

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  • a.廊坊市第四人民医院 神经内科,河北 廊坊 065700
    b.廊坊市第四人民医院 心血管内科,河北 廊坊 065700
    c.廊坊市第四人民医院 超声诊断科,河北 廊坊 065700
郑朝霞 E-mail:zyx197203@163.com

收稿日期: 2023-04-23

  网络出版日期: 2024-04-28

基金资助

廊坊市科学技术研究与发展计划(2023013013)

Value of remnant lipoprotein cholesterol and homocysteine in predicting new-onset atrial fibrillation in elderly patients with acute myocardial infarction

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  • a. Department of Neurology, Fourth People’s Hospital of Langfang, Langfang 065700, China
    b. Department of Cardiovascular Medicine, Fourth People’s Hospital of Langfang, Langfang 065700, China
    c. Ultrasound Diagnosis Department, Fourth People’s Hospital of Langfang, Langfang 065700, China

Received date: 2023-04-23

  Online published: 2024-04-28

摘要

目的: 探讨残粒胆固醇(remnant lipoprotein cholesterol,RLP-C)、同型半胱氨酸(homocysteine,Hcy)预测老年急性心肌梗死(acute myocardial infarction,AMI)患者新发心房颤动(房颤)的价值。方法: 选择2018年1月至2023年6月廊坊市第四人民医院心内科收治住院的449例老年AMI患者为研究对象,根据住院期间是否有新发房颤分为房颤组90例和非房颤组359例。收集2组患者相关临床资料,利用Logistic回归分析新发房颤的危险因素,采用受试者操作特征(receiver operating characteristic, ROC)曲线判断各指标对新发房颤的预测效果。结果: 与非房颤组比较,房颤组入院时心率、RLP-C、Hcy水平升高(P<0.05)。2组心功能Killip分级差异有统计学意义(P<0.05)。Logistic回归分析显示,入院时心率、RLP-C、Hcy为新发房颤发生的独立危险因素(P<0.05)。ROC曲线分析显示,RLP-C、Hcy及两者联合预测老年AMI患者新发房颤的曲线下面积(area under curve, AUC)分别为0.761、0.720和0.845,RLP-C、Hcy联合预测的AUC均高于单一预测的AUC(Z=3.061、3.692,P<0.05)。结论: RLP-C、Hcy为老年AMI患者新发房颤的独立预测因子,两者联合能进一步提升预测价值。

本文引用格式

李晴, 郑朝霞, 罗静慧, 李莉, 牛福英 . 残粒胆固醇、同型半胱氨酸预测老年急性心肌梗死患者新发心房颤动的价值[J]. 内科理论与实践, 2024 , 19(01) : 68 -71 . DOI: 10.16138/j.1673-6087.2024.01.12

Abstract

Objective To investigate the value of remnant lipoprotein cholesterol(RLP-C)and homocysteine(Hcy)in predicting new-onset atrial fibrillation(AF) in elderly patients with acute myocardial infarction(AMI). Methods A total of 449 elderly patients with AMI admitted to the Cardiology Department of Langfang Fourth People’s Hospital from January 2018 to June 2023 were enrolled as the research objects. The patients were divided into AF group (n=90) and non-AF group (n=359) according to the occurrence of new-onset AF during hospitalization. The clinical data of the two groups were collected. Logistic regression was used to analyze the risk factors of new-onset AF, and receiver operating characteristic (ROC) curve was used to judge the predictive effect of each index on new-onset AF. Results Compared with the non-AF group, the heart rate on admission, RLP-C and Hcy levels in the AF group were increased (P<0.05). There were significant differences in Killip grades between the two groups (P<0.05). Logistic regression analysis showed that heart rate on admission, RLP-C and Hcy were independent risk factors for new-onset AF (P<0.05). ROC curve analysis showed that the AUC of RLP-C, Hcy and their combination in predicting new-onset AF in elderly patients with AMI were 0.761, 0.720 and 0.845, respectively. The AUC of RLP-C and Hcy combined prediction was higher than that of single prediction (Z=3.061, 3.692, P<0.05). Conclusions RLP-C and Hcy are independent predictors of new-onset AF in elderly patients with AMI. The combination of RLP-C and Hcy can further improve the predictive value.

参考文献

[1] Tseng CH, Chung WJ, Li CY, et al. Statins reduce new-onset atrial fibrillation after acute myocardial infarction[J] .Medicine (Baltimore), 2020, 99(2):e18517.
[2] Fauchier L, Bisson A, Bodin A, et al. Outcomes in patients with acute myocardial infarction and new atrial fibrillation[J] .Clin Res Cardiol, 2021, 110(9):1431-1438.
[3] Obayashi Y, Shiomi H, Morimoto T, et al. Newly diagnosed atrial fibrillation in acute myocardial infarction[J]. J Am Heart Assoc, 2021, 10(18):e021417.
[4] 刘力黎, 陈诚, 张丽敏. 血脂水平与心房颤动相关性研究进展[J]. 心血管病学进展, 2021, 42(6):539-542.
[5] Watts M, Kolluru GK, Dherange P, et al. Decreased bioavailability of hydrogen sulfide links vascular endothelium and atrial remodeling in atrial fibrillation[J]. Redox Biol, 2021, 38:101817.
[6] 杜冬杰, 陈健, 王诗悦, 等. 血残粒胆固醇水平与冠心病和心肌梗死风险的两样本孟德尔随机化研究[J]. 中国动脉硬化杂志, 2023, 31(6):510-516.
[7] Svenningsson MM, Svingen GFT, Lysne V, et al. Transsulfuration metabolites and the association with incident atrial fibrillation - an observational cohort study among Norwegian patients with stable angina pectoris[J]. Int J Cardiol, 2020, 317:75-80.
[8] 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 急性ST段抬高型心肌梗死诊断和治疗指南(2019)[J]. 中华心血管病杂志, 2019, 47(10) :766-783.
[9] 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 非ST段抬高型急性冠状动脉综合征诊断和治疗指南[J]. 中华心血管病杂志, 2017, 45(5):359-376.
[10] 孙楷文, 王虹艳. 残粒胆固醇在动脉粥样硬化相关疾病中的研究进展[J]. 中华高血压杂志, 2023, 31(5):419-424.
[11] 黄从新, 张澍, 黄德嘉, 等. 心房颤动:目前的认识和治疗的建议-201[J]. 中华心律失常学杂志, 2018, 22( 4) : 279-346.
[12] Fauchier L, Bisson A, Bodin A, et al. Outcomes in patients with acute myocardial infarction and new atrial fibrillation:a nationwide analysis[J]. Clin Res Cardiol, 2021, 110(9):1431-1438.
[13] Congo KH, Belo A, Carvalho J, et al. New-onset atrial fibrillation in ST-segment elevation myocardial infarction[J]. Arq Bras Cardiol, 2019, 113(5):948-957.
[14] Nagai M, Itoh T, Ishida M, et al. New-onset atrial fibrillation in patients with acute coronary syndrome may be associated with worse prognosis and future heart failure[J]. J J Arrhythm, 2019, 35(2):182-189.
[15] 毕昌龙, 张侃迪, 周恩, 等. 急性心肌梗死患者住院期间新发心房颤动危险因素分析及预测模型的建立[J]. 临床心血管病杂志, 2021, 37(8):731-735.
[16] 董红科, 马东超, 李静, 等. 老年住院患者血脂与非瓣膜性心房颤动的相关性研究[J]. 南京医科大学学报(自然科学版), 2020, 40(10):1484-1490.
[17] Chait A, Ginsberg HN, Vaisar T, et al. Remnants of the triglyceride-rich lipoproteins, diabetes, and cardiovascular disease[J]. Diabetes, 2020, 69(4):508-516.
[18] 吴英浪, 路英杰, 王晓云. 同型半胱氨酸代谢紊乱对内皮功能障碍影响的研究进展[J]. 医学综述, 2020, 26(13):2513-2517.
[19] 余平, 李叶子, 万少兵. 抑制沉默信息调节因子1/p53通路对同型半胱氨酸诱导的心肌纤维化的影响[J]. 广西医学, 2021, 43(19):2322-2326.
[20] 张兵兵, 李结华. 心房颤动患者同型半胱氨酸、胱抑素C与颈动脉粥样硬化、左心房内径的相关性研究[J]. 国际老年医学杂志, 2021, 42(5):261-263.
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