https://scholars.lib.ntu.edu.tw/handle/123456789/466318
標題: | Dyslipidemias have a detrimental effect on left ventricular systolic function in patients with a first acute myocardial infarction | 作者: | TZUNG-DAU WANG CHAU-CHUNG WU WEN-JONE CHEN CHII-MING LEE MING-FONG CHEN Liau C.-S. Sung F.-C. Lee Y.-T. |
公開日期: | 1998 | 卷: | 81 | 期: | 5 | 起(迄)頁: | 531-537 | 來源出版物: | American Journal of Cardiology | 摘要: | Several large-scale clinical trials have shown that lipid-lowering interventions are associated with reduced coronary events and mortality. However, whether dyslipidemias have a detrimental effect on the evolution of myocardial infarction (MI) is still unknown. To examine whether dyslipidemias can aggravate myocardial vulnerability following MI, 165 patients with a first MI were studied. All patients underwent measurements of serum lipid profiles 1 week and 3 months after MI, a radionuclide ventriculographic study, and a coronary angiographic study. The patients were divided into 3 groups according to their 3-month serum cholesterol levels (group 1, <200 mg/dl; group 2, 200 to 240 mg/dl; group 3, >240 mg/dl). Groups 1, 2, and 3 consisted of 66, 59, and 40 patients, respectively. Group 3 had a higher Gensini score than groups 1 and 2, although this was not statistically significant (p = 0.13). The postinfarct left ventricular ejection fraction (LVEF) was highest in group 1 (53 ± 13%), at mid level in group 2 (43 ± 14%), and lowest in group 3 (35 ± 11%) (p <0.0001). A significant negative correlation between 3-month low-density lipoprotein (LDL) cholesterol (r = - 0.55, p<0.0001) and the postinfarct LVEF was found. The product of peak creatine kinase (CK(MAX)) and time to CK(MAX) (p = 0.001), and patency of the infarct-related artery (p = 0.009), rather than variables of coronary atherosclerosis, were also independent predictors of the postinfarct LVEF. Increases in 1-week LDL cholesterol and decreases in 1-week high-density lipoprotein cholesterol were associated with a higher CK(MAX) and a lower patency rate of the infarct-related artery, respectively. This study revealed that dyslipidemias per se, especially LDL cholesterol, had a detrimental effect on the postinfarct LVEF; this effect might be independent of the atherogenic properties of dyslipidemias. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/466318 | ISSN: | 0002-9149 | DOI: | 10.1016/S0002-9149(97)00974-0 | SDG/關鍵字: | creatine kinase; low density lipoprotein cholesterol; acute heart infarction; adult; aged; article; controlled study; coronary artery atherosclerosis; disease course; dyslipidemia; female; heart left ventricle failure; human; lipoprotein metabolism; major clinical study; male; priority journal; risk factor; Aged; Cholesterol, LDL; Coronary Angiography; Creatine Kinase; Female; Gated Blood-Pool Imaging; Humans; Hyperlipidemias; Linear Models; Male; Middle Aged; Myocardial Infarction; Stroke Volume; Systole; Vascular Patency; Ventricular Function, Left |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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