The relationship between apolipoprotein B/apolipoprotein A1, total cholesterol/high-density lipoprotein cholesterol and adverse cardiovascular events in ST segment elevation myocardial infarction patients after interventional therapy
10.3760/cma.j.cn115455-20241106-00970
- VernacularTitle:载脂蛋白B/载脂蛋白A1、总胆固醇/高密度脂蛋白胆固醇与ST段抬高型心肌梗死患者介入治疗后心血管不良事件的关系
- Author:
Fan FAN
1
;
Lipeng HUANG
Author Information
1. 西安医学院第一附属医院全科医学二科，西安 710000
- Publication Type:Journal Article
- Keywords:
ST-segment elevation myocardial infarction;
Percutaneous coronary intervention;
Major adverse cardiovascular events;
Apolipoproteins;
Cholesterol;
Choleste
- From:
Chinese Journal of Postgraduates of Medicine
2025;48(9):823-830
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between serum apolipoprotein B (ApoB)/ apolipoprotein A1 (ApoA1), total cholesterol (TC)/ high-density lipoprotein cholesterol (HDL-C), and major adverse cardiovascular events (MACE) in patients with ST-segment elevation myocardial infarction (STEMI) after interventional therapy.Methods:This study was a retrospective analysis of 180 patients with STEMI who completed percutaneous coronary intervention (PCI) in the Xidian Group Hospital between January 2020 and December 2023. Based on the occurrence of MACE during the 6-month follow-up period after PCI, the patients were divided into MACE group of 25 cases and non MACE group of 155 cases. The general data, serum ApoB/ApoA1, TC/HDL-C before PCI and laboratory test data were compared between the two groups. The relationship between serum ApoB/ApoA1, TC/HDL-C and MACE in STEMI patients after interventional therapy was analyzed.Results:The proportion of Killip heart function grade Ⅲ, serum cardiac troponin I, B-type natriuretic peptide, ApoB, TC, ApoB/ApoA1 and TC/HDL-C in the MACE group were higher than those in the non MACE group: 64.00% (16/25) vs. 41.94% (65/155), (134.23 ± 20.21) ng/L vs. (122.18 ± 19.41) ng/L, (75.23 ± 16.18) ng/L vs. (68.22 ± 15.49) ng/L, (1.08 ± 0.23) g/L vs. (0.95 ± 0.25) g/L, (5.20 ± 0.85) mmol/L vs. (4.82 ± 0.81) mmol/L, 0.92 (0.78, 1.06) vs. 0.74 (0.61, 0.87), 4.28 (3.71, 4.91) vs. 3.72 (3.11, 4.31). The levels of ApoA1 and HDL-C were lower in the MACE group compared to the non MACE group: (1.19 ± 0.21) g/L vs. (1.30 ± 0.26) g/L, (1.21 ± 0.13) mmol/L vs. (1.31 ± 0.21) mmol/L, with statistically significant differences ( P<0.05). Logistic regression analysis found that the occurrence of MACE in STEMI patients after interventional treatment was related to serum cardiac troponin I, ApoB, ApoB/ApoA1 and TC/HDL-C ( P<0.05). Restrictive cubic spline analysis showed a non-linear dose-response relationship between serum ApoB/ApoA1, TC/HDL-C and MACE after interventional treatment in STEMI patients ( P<0.05). When serum ApoB/ApoA1 ≥ 0.76 and TC/HDL-C ≥ 3.86, the risk of MACE in patients increased with the increase of both ratios. The serum ApoB/ApoA1 and TC/HDL-C had a positive interactive effect on the occurrence of MACE in STEMI patients after interventional therapy. The decision curve and column chart showed that the predictive model constructed with the assistance of serum ApoB/ApoA1 and TC/HDL-C had ideal predictive value for MACE after interventional treatment in STEMI patients. Conclusions:The occurrence of MACE in STEMI patients after interventional treatment is related to the serum ApoB/ApoA1 and TC/HDL-C. The risk of MACE increases with the increase of these two ratios, and they have a positive interaction with MACE occurrence, which can be used as an auxiliary indicator for early assessment of MACE occurrence.
