急性心肌梗死接受直接冠状动脉介入治疗患者血脂水平与预后的关联性分析

目的：探讨急性ST段抬高心肌梗死(STEMI)患者的血脂水平对直接冠状动脉介入治疗(PCI)后1年内主要不良心脑血管事件(MACCE)的影响，阐明急性期血脂水平和他汀药物干预后的血脂水平与预后的关联性。方法：选择624例STEMI患者，根据入院后24 h内低密度脂蛋白胆固醇(LDL-C)水平将患者分为正常组380例(L...

Relevance analysis between lipid level of patients with acute myocardial infarction treated with percutaneous coronary intervention and prognosis

Objective To evaluate the correlation between the lipid level of ST segment elevation myocardial infarction(STEMI) patients after treated with percutaneous coronary intervention(PCI) for 1 year and to clarify the relationship between lipid level and prognosis.Methods Based on the LDL-C level within 24 h after admission,624 patients with STEMI underwent primary PCI were divided into normal group(LDL-C<3.37 mmol·L-1,n=380),LDLC marginal increased group(LDL-C 3.37-4.14 mmol·L-1,n=159) and LDL-C increased group(LDL-C>4.14 mmol·L-1,n=85).Of these 624 patients,the serum lipid levels of 335 patients after statins treatment for 4 weeks after discharged were collected underwent follow-up in outpatient settings,and these 335 patients were divided into target group(LDL-C<1.81 mmol·L-1,n=77) and non-target group(LDL-C≥1.81 mmol·L-1,n=258).The relationship between the lipid level of acute period and MACCE prognosis after treatment was studied.Results The occurrence rate of MACCE(cardiac death,ischemic stroke and recurrent myocardial infarction and composite events) had no significant differences between three groups(P>0.05).After statins treatment,the target group got one MACCE patients(1.3%),which was significantly lower than that in non-target group(7.4%)(P<0.05).Logistic regression analysis showed a significant relationship between the triglyceride(TG) level at acute stage and ischemic stroke(OR=1.226;95% CI:1.068-1.407;P<0.05),so did the LDL-C level after statins treatment and MACCE(OR=1.788;95% CI:1.091-5.233;P<0.05).Smoking history(OR=0.136;95% CI:0.016-0.115;P<0.05) and higher SYNTAX score(OR=1.544;95% CI:5.387-33.522;P<0.05) were also influence factors of MACCE.Conclusion The different levels of LDL-C of patients at acute stage are not related with MACCE,but it is related with the MACCE of the patients with unnormal LDL-C level after statins treatment.