脂蛋白a水平升高预测维持性血液透析患者全因死亡及心血管事件
FU Xin-yi1
BAI Ma-qiao2
LEI Chen-yu3
XU An-ning1
YUAN Lin-lin3
CAI Wen-jing4
ZHANG Li3
YE Zhi-ming3
LI Zhi-lian1
1.Department of Nephrology,Guangdong Cardiovascular Institute,Guangdong Provincial People's Hospital(Guangdong Acade-my of Medical Sciences),Southern Medical University,Guangzhou,510080,China2.Department of Nephrology,Linzhi People's Hos-pital,Linzhi,Tibet,China3.Department of Nephrology,Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou,China4.Department of Nephrology,Heyuan People's Hospital,Guangdong Pro-vincial People's Hospital Heyuan Hospital,Heyuan,China
摘要：Background Lipoprotein(a)[Lp(a)]has been demonstrated to be closely associated with the development of cardiovascular disease(CVD),but its prognostic value in maintenance hemodialysis(MHD)patients remains con-troversial.This study aimed to evaluate the association between Lp(a)levels and adverse outcomes in this high-risk population,with a focus on both mortality and new-onset cardiovascular events(CV events).Methods In this retrospective observational study,we enrolled181 MHD patients who were stratified into normal Lp(a)level group[Lp(a)≤300 mg/L,n=112]and elevated Lp(a)level group[Lp(a)>300 mg/L,n=69].Survival analysis was per-formed using Kaplan-Meier curves,and Cox regression models were employed to evaluate the impact on all-cause mortalityand new-onset CV events.Results Over a median follow-up of 79.0 months(IQR:45.0-109.0),the elevat-ed Lp(a)group exhibited significantly increased CV events incidence(79.7%vs.29.5%,P<0.001).Elevated Lp(a)was independently associated with higher risks of all-cause mortality(multivariable-adjusted HR:2.220,95%CI:1.039-4.740)and new-onset CV events(HR:3.614,95%CI:2.164-6.035).Each 10 mg/L Lp(a)increment con-ferred a 1.1%increased cardiovascular risk(P<0.001).Conclusions Elevated Lp(a)is a strong,independent pre-dictor of all-cause mortality and new-onset CV events in MHD patients.These findings highlighted the potential utility of Lp(a)in routine CVD risk assessment and underscored the need for targeted therapies to mitigate residu-al risk in this population.[S Chin J Cardiol 2025;26(2):59-68]
机标关键词：维持性血液透析患者心血管事件脂蛋白a全因死亡
论文发表日期：2025-06-30
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：10( 59-68 )
英文信息