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Association of lipoprotein(a) with platelet aggregation and thrombogenicity in patients undergoing percutaneous coronary intervention

机译：脂蛋白（A）与血小板聚集和经皮冠状动脉介入患者的血小板聚集和血栓形成性

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摘要

This study aimed to evaluate the association of lipoprotein(a) levels with platelet aggregation and thrombogenicity in patients undergoing percutaneous coronary intervention (PCI), and to investigate the ischemic outcome on this population. Lipoprotein(a) and modified thrombelastography were measured in 6601 consecutive patients underwent PCI on dual antiplatelet therapy. Cox proportional regression analysis was applied to illustrate the ischemic events in a 2-year follow up. The mean levels of lipoprotein(a) were 29.0 mg/dl. Patients with higher lipoprotein(a) levels had significantly accelerated fibrin generation (lower K time and bigger alpha angle) and greater clot strength (higher maximum amplitude (MA)) than patients with lower lipoprotein(a) levels (P< .001). Moreover, the higher lipoprotein(a) group also exhibited significantly higher adenosine diphosphate (ADP) induced platelet aggregation (MA(ADP)) by thrombelastography platelet mapping assay than lower lipoprotein(a) group. Cox regression analyzes revealed that patients with higher lipoprotein(a) levels had a 16% higher risk of major adverse cardiovascular and cerebrovascular events (HR 1.159, 95%CI: 1.005-1.337,P= .042) compared with patients with lower lipoprotein(a) levels. This association persisted after adjustment for a broad spectrum of risk factors (HR 1.174, 95%CI: 1.017-1.355,P= .028). High plasma lipoprotein(a) levels were associated with increased platelet aggregation and ischemic events in patients underwent PCI. Lipoprotein(a) might indicate the need for prolonged antiplatelet therapy.
机译：本研究旨在评估接受经皮冠状动脉介入治疗（PCI）患者的脂蛋白（a）水平与血小板聚集和血栓形成的关系，并调查该人群的缺血结局。在6601名接受PCI双重抗血小板治疗的患者中，测量了脂蛋白（a）和改良血栓造影术。Cox比例回归分析用于说明2年随访中的缺血性事件。脂蛋白（a）的平均水平为29.0 mg/dl。与脂蛋白（a）水平较低的患者相比，脂蛋白（a）水平较高的患者显著加快了纤维蛋白生成（较低的K时间和较大的α角）和更大的血栓强度（较高的最大振幅（MA））（P<0.001）。此外，与低脂蛋白（a）组相比，高脂蛋白（a）组通过血栓造影血小板标测法也显示出显著更高的腺苷二磷酸（ADP）诱导的血小板聚集（MA（ADP））。Cox回归分析显示，与脂蛋白（a）水平较低的患者相比，脂蛋白（a）水平较高的患者发生重大不良心脑血管事件的风险（HR 1.159，95%CI:1.005-1.337，P=.042）高16%。在对广泛的风险因素进行调整后，这种关联仍然存在（HR 1.174，95%置信区间：1.017-1.355，P=0.028）。在接受PCI的患者中，高血浆脂蛋白（a）水平与血小板聚集增加和缺血性事件相关。脂蛋白（a）可能表明需要长期抗血小板治疗。

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  • 来源
    《Platelets》 |2021年第5期|共6页
  • 作者

    Zhu Pei; Tang Xiao-Fang; Song Ying; Zhang Yin; Gao Li-Jian; Gao Zhan; Chen Jue; Yang Yue-Jin; Gao Run-Lin; Xu Bo; Yuan Jin-Qing;

  • 作者单位

    Chinese Acad Med Sci &

    Peking Union Med Coll Natl Ctr Cardiovasc Dis Dept Cardiol State Key Lab;

    Chinese Acad Med Sci &

    Peking Union Med Coll Natl Ctr Cardiovasc Dis Dept Cardiol State Key Lab;

    Chinese Acad Med Sci &

    Peking Union Med Coll Natl Ctr Cardiovasc Dis Dept Cardiol State Key Lab;

    Chinese Acad Med Sci &

    Peking Union Med Coll Natl Ctr Cardiovasc Dis Dept Cardiol State Key Lab;

    Chinese Acad Med Sci &

    Peking Union Med Coll Natl Ctr Cardiovasc Dis Dept Cardiol State Key Lab;

    Chinese Acad Med Sci &

    Peking Union Med Coll Natl Ctr Cardiovasc Dis Dept Cardiol State Key Lab;

    Chinese Acad Med Sci &

    Peking Union Med Coll Natl Ctr Cardiovasc Dis Dept Cardiol State Key Lab;

    Chinese Acad Med Sci &

    Peking Union Med Coll Natl Ctr Cardiovasc Dis Dept Cardiol State Key Lab;

    Chinese Acad Med Sci &

    Peking Union Med Coll Natl Ctr Cardiovasc Dis Dept Cardiol State Key Lab;

    Chinese Acad Med Sci &

    Peking Union Med Coll Natl Ctr Cardiovasc Dis Dept Cardiol State Key Lab;

    Chinese Acad Med Sci &

    Peking Union Med Coll Natl Ctr Cardiovasc Dis Dept Cardiol State Key Lab;

  • 收录信息
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 基础医学;
  • 关键词

    Lipoprotein(a); major adverse cardiovascular and cerebrovascular events; percutaneous coronary intervention; platelet aggregation; thrombelastography;

    机译：脂蛋白（A）;主要不良心血管和脑血管事件;经皮冠状动脉介入;血小板聚集;血栓塑料;

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