بررسی مقایسه‌ای سطوح سرمی آپولیپوپروتئین (a) و لیپوپروتئین با ظرفیت بالا در بیماران آنژیوگرافی شده با تنگی انسدادی و غیر انسدادی

نوع مقاله : Original Article(s)

نویسندگان

1 دستیار قلب و عروق، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی تهران، تهران، ایران

2 دانشیار، گروه قلب و عروق، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی تهران، تهران، ایران

چکیده

مقاله پژوهشی




مقدمه: هدف از این مطالعه، بررسی مقایسه‌ای ارتباط بیماران مبتلا به بیماری عروق کرونر با تغییرات پروفایل لیپیدی در بیمارستان شریعتی تهران طی سال‌های 1397 تا 1399 می‌باشد.
روش‌ها: پژوهش حاضر یک مطالعه‌ی مقطعی است که طی سال‌های 1397 تا 1399 در بیمارستان دکتر شریعتی تهران بر روی بیماران مبتلا به تنگی عروق انجام گردید. اطلاعات پایه و سابقه‌ی بیماری‌هایی نظیر فشارخون بالا و هایپرلیپیدمی از پرونده‌ی بیماران بدست آمد. همچنین سطح سرمی پروفایل لیپید شامل کلسترول، تری‌گلیسرید، لیپوپروتئین ( a) Apoa و (High-density lipoprotein)  HDLدر این بیماران اندازه‌گیری و بین دو گروه مقایسه شد.
یافته‌ها: در این مطالعه، 332 بیمار مبتلا به تنگی عروق کرونر وارد مطالعه شدند که بر اساس نتایج آنژیوگرافی، 169 بیمار مبتلا به  تنگی عروق کرونر غیر انسدادی و 163 نفر مبتلا به تنگی عروق انسدادی بودند. میانگین سطح پروفایل لیپیدی از جمله کلسترول تری‌گلیسرید (Low-density lipoprotein) LDL، (High-density lipoprotein) HDL و آپولیپوپروتئین‌های  Apo (a)و ( Apo (bدر بیماران دارای تنگی عروق کرونر انسدادی و غیر انسدادی اختلاف معنی‌دار نداشت، در حالی‌که سطح لیپوپروتئین (a) در بیماران مبتلا به تنگی عروق کرونر انسدادی بالاتر بود (0/001 = P).
نتیجه‌گیری: بر اساس یافته‌های مطالعه‌ی حاضر، لیپوپروتئین (a) بصورت مستقل با افزایش خطر ابتلا به بیماری عروق کرونری همراه بوده است. لذا از این شاخص می‌توان برای پیشگویی ابتلا به بیماری عروق کرونری و شروع یا تشدید درمان‌های پیشگیرانه استفاده نمود. مطالعات بیشتری در این زمینه توصیه می‌گردد.

تازه های تحقیق

آریمه مرادی مسیحی: Google Scholar, PubMed

شاهین شیرانی: Google Scholar

عبدالحسین طباطبایی: Google Scholar, PubMed

عباس محققی: Google Scholar, PubMed

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Comparative Study of Apo-Lipoprotein(a) and High-Density Lipoprotein Levels in Patients Under Coronary Angiography with Obstructive and Non-Obstructive Stenosis

نویسندگان [English]

  • Arimeh Moradi Masihi 1
  • Shahin Shirani 2
  • Seyed Abdolhosein Tabatabaei 2
  • Abbas Mohagheghi 2
1 Resident of Cardiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
2 Associate Professor, Department of Cardiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
چکیده [English]

Background: The purpose of this study is to compare the relationship between patients with coronary artery disease and lipid profile changes in Shariati Hospital during the years 2017-2019.
Methods: The present study is a cross-sectional study that was conducted during 2017 -2019 at Dr. Shariati Hospital in Tehran on patients with vascular stenosis. Basic information and history of diseases such as high blood pressure and hyperlipidemia were obtained from patients' records. The lipid profile of the patients was measured, including cholesterol, triglyceride, lipoprotein Apoa (a), and HDL, and then compared between the two groups.
Findings: In this study, 332 patients with coronary artery stenosis were included in the study, based on angiography results, 169 patients had non-obstructive coronary artery stenosis and 163 patients had obstructive coronary artery stenosis. There was no significant difference in the mean level of lipid profile, including cholesterol, Low-density lipoprotein (LDL), High-density lipoprotein (HDL), triglycerides, and apolipoproteins Apo (a) and Apo (b) in patients with obstructive and non-obstructive coronary artery stenosis, while the level of lipoprotein (a) was higher in patients with obstructive coronary artery stenosis. (P = 0.001).
Conclusion: According to the present study, an independent association was found between lipoprotein A and increased risk of coronary artery disease. Therefore, this index can be used to predict coronary artery disease and start or intensify preventive treatments. More studies in this field are recommended.

کلیدواژه‌ها [English]

  • Apo lipoprotein
  • Coronary artery stenosis
  • Obstructive stenosis

مراجع

  1. Sadeghi M, Heshmat-Ghahdarijani K, Talaei M, Safaei A, Sarrafzadegan N, Roohafza H. The predictive value of atherogenic index of plasma in the prediction of cardiovascular events; a fifteen-year cohort study. Adv Med Sc 2021; 66(2): 418-23.
  2. Khosravi A, Sadeghi M, Farsani ES, Danesh M, Heshmat-Ghahdarijani K, Roohafza H, et al. Atherogenic index of plasma: A valuable novel index to distinguish patients with unstable atherogenic plaques. J Res Med Sci 2022; 27: 45.
  3. Hashemi M, Ostovan J, Sadeghi M, Safaei A, Sanaei S. Does adjunctive prophylactic intracoronary infusion of low dose Alteplase prevent no-reflow phenomenon during primary percutaneous coronary intervention? ARYA Atherosclerosis Journal 2023; 19(6): 36-43.
  4. Roohafza H, Heidari R, Safaei A, Masoumi G, Soleimani A, Sadeghi M. The role of sense of coherence in the outcomes of acute myocardial infarction survivors; a two-year cohort study [in Persian]. Mashhad Univ Med Sci 2021: 57(4): 636-46.
  5. Kermani-Alghoraishi M, Heshmat-Ghahdarijani K, Sanei H, Sadeghi M, Asadi A, Safaei A. Does allopurinol improve inflammatory biomarkers and post-revascularization coronary blood flow in Non-STEMI patients? Eur J Prev Cardiol 2022; 29(Suppl 1): zwac056. 5.
  6. Morabia A, Abel T. The WHO report "Preventing chronic diseases: a vital investment" and us. Soz Praventivmed 2006; 51(2): 74.
  7. Cai G, Liu W, Lv S, Wang X, Guo Y, Yan Z, et al. Gender-specific associations between atherogenic index of plasma and the presence and severity of acute coronary syndrome in very young adults: a hospital-based observational study. Lipids Health Dis 2019; 18(1): 99.
  8. Shao C, Wang J, Tian J, Tang Yd. Coronary artery disease: from mechanism to clinical practice. Adv Exp Med Biol 2020; 1177: 1-36.
  9. Behbodikhah J, Ahmed S, Elyasi A, Kasselman LJ, De Leon J, Glass AD, et al. Apolipoprotein B and cardiovascular disease: biomarker and potential therapeutic target. Metabolites 2021; 11(10): 690.
  10. Varvel S, McConnell JP, Tsimikas S. Prevalence of elevated Lp (a) mass levels and patient thresholds in 532 359 patients in the United States. Arteriosclerosis, Thrombosis, and Vascular Biology. 2016;36(11):2239-45.
  11. Lau FD, Giugliano RP. Lipoprotein (a) and its
    significance in cardiovascular disease: a review. JAMA Cardiol 2022; 7(7): 760-9.
  12. Jang AY, Han SH, Sohn IS, Oh PC, Koh KK. Lipoprotein(a) and Cardiovascular Diseases - Revisited. Circ J 2020; 84(6): 867-74.
  13. Gilliland TC, Liu Y, Mohebi R, Miksenas H, Haidermota S, Wong M, et al. Lipoprotein (a), oxidized phospholipids, and coronary artery disease severity and outcomes. J Am Coll Cardiol 2023; 81(18): 1780-92.
  14. Liu H-H, Cao Y-X, Jin J-L, Zhang H-W, Hua Q, Li Y-F, et al. Association of lipoprotein (a) levels with recurrent events in patients with coronary artery disease. Heart 2020; 106(16): 1228-35.
  15. Kamstrup PR. Lipoprotein (a) and cardiovascular disease. Clin Chem 2021; 67(1): 154-66.
  16. Danesh J, Collins R, Peto R. Lipoprotein (a) and coronary heart disease: meta-analysis of prospective studies. Circulation 2000; 102(10): 1082-5.
  17. Mach F, Baigent C, Catapano AL, Koskinas KC, Casula M, Badimon L, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS). Eur Heart J 2020; 41(1): 111-88.
  18. Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 2019; 139(25): e1082-e143.
  19. Mitsuda T, Uemura Y, Ishii H, Tanaka A, Takemoto K, Koyasu M, et al. Prognostic impact of lipoprotein (a) levels during lipid management with statins after ST-elevation acute myocardial infarction. Coron Artery Dis 2019; 30(8): 600-7.
  20. Shitara J, Kasai T, Konishi H, Endo H, Wada H, Doi S, et al. Impact of lipoprotein (a) levels on long-term outcomes in patients with coronary artery disease and left ventricular systolic dysfunction. Circ J 2019; 83(5): 1047-53.
  21. Saleheen D, Haycock PC, Zhao W, Rasheed A, Taleb A, Imran A, et al. Apolipoprotein (a) isoform size, lipoprotein (a) concentration, and coronary artery disease: a mendelian randomisation analysis. Lancet Diabetes Endocrinol 2017; 5(7): 524-33.
  22. Schmidt K, Noureen A, Kronenberg F, Utermann G. Structure, function, and genetics of lipoprotein (a).
    J Lipid Res 2016; 57(8): 1339-59.
  23. Papathanasiou KA, Kazantzis D, Rallidis LS. Lipoprotein (a) is associated with premature coronary artery disease: a meta-analysis. Coron Artery Dis 2023; 34(4): 227-35.
  24. Tsimikas S, Brilakis ES, Miller ER, McConnell JP, Lennon RJ, Kornman KS, et al. Oxidized phospholipids, Lp (a) lipoprotein, and coronary artery disease. N Engl J Med 2005; 353(1): 46-57.
  25. Liu HH, Cao YX, Jin JL, Zhang HW, Hua Q, Li YF, et al. Predicting cardiovascular outcomes by baseline lipoprotein (a) concentrations: a large cohort and long‐term follow‐up study on real‐world patients receiving percutaneous coronary intervention. JAHA 2020; 9(3): e014581.
  26. Tsimikas S, Karwatowska-Prokopczuk E, Gouni-Berthold I, Tardif J-C, Baum SJ, Steinhagen-Thiessen E, et al. Lipoprotein (a) reduction in persons with cardiovascular disease. N Engl J Med 2020; 382(3): 244-55.
  27. Zeitouni M, Clare RM, Chiswell K, Abdulrahim J, Shah N, Pagidipati NP, et al. Risk factor burden and long‐term prognosis of patients with premature coronary artery disease. J Am Heart Assoc 2020; 9(24): e017712.
  28. Van Rosendael AR, Bax AM, Smit JM, Van Den Hoogen IJ, Ma X, Al’Aref S, et al. Clinical risk factors and atherosclerotic plaque extent to define risk for major events in patients without obstructive coronary artery disease: the long-term coronary computed tomography angiography CONFIRM registry. Eur Heart J Cardiovasc Imaging 2020; 21(5): 479-88.
  29. van Bussel E, Hoevenaar-Blom M, Poortvliet R, Gussekloo J, van Dalen J, van Gool W, et al. Predictive value of traditional risk factors for cardiovascular disease in older people: A systematic review. Prev Med 2020; 132: 105986.
  30. Tajmirriahi DM, Saadatnia M, Shemirani H, Sadeghi M, Chamasemani A, Safaei A. The incidence of cardiovascular events in small versus large ischemic stroke; a three-year cohort study. ARYA Atherosclerosis Journal. 2023;19(5): 35-42.
  31. Zhao X, Wang D, Qin L. Lipid profile and prognosis in patients with coronary heart disease: a meta-analysis of prospective cohort studies. BMC Cardiovasc Disord 2021; 21: 1-15.
  32. Liou L, Kaptoge S. Association of small, dense LDL-cholesterol concentration and lipoprotein particle characteristics with coronary heart disease: a systematic review and meta-analysis. PLoS One 2020; 15(11): e0241993.
مجله دانشکده پزشکی اصفهان
دوره 41، شماره 747
هفته 3، بهمن
بهمن و اسفند 1402
صفحه 1096-1103

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سابقه مقاله

  • تاریخ دریافت: 24 آبان 1402
  • تاریخ پذیرش: 28 فروردین 1403

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