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Open Access

Circulating lipid and lipoprotein profiles and their correlation to cardiac function and cardiovascular outcomes in patients with acute myocardial infarction

Haoyu Wu, Chen Wang, Gulinigaer Tuerhongjiang, Xiangrui Qiao, Yiming Hua, Jianqing She, Zuyi Yuan
DOI: 10.1136/jim-2021-001803 Published 27 September 2021
Haoyu Wu
1 Department of Cardiovascular Medicine, Xi'an Jiaotong University Medical College First Affiliated Hospital, Xi'an, China
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Chen Wang
1 Department of Cardiovascular Medicine, Xi'an Jiaotong University Medical College First Affiliated Hospital, Xi'an, China
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Gulinigaer Tuerhongjiang
1 Department of Cardiovascular Medicine, Xi'an Jiaotong University Medical College First Affiliated Hospital, Xi'an, China
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Xiangrui Qiao
1 Department of Cardiovascular Medicine, Xi'an Jiaotong University Medical College First Affiliated Hospital, Xi'an, China
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Yiming Hua
1 Department of Cardiovascular Medicine, Xi'an Jiaotong University Medical College First Affiliated Hospital, Xi'an, China
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Jianqing She
1 Department of Cardiovascular Medicine, Xi'an Jiaotong University Medical College First Affiliated Hospital, Xi'an, China
2 Key Laboratory of Molecular Cardiology, Xi'an Jiaotong University, Xi'an, China
3 Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University Ministry of Education, Xi'an, China
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Zuyi Yuan
1 Department of Cardiovascular Medicine, Xi'an Jiaotong University Medical College First Affiliated Hospital, Xi'an, China
2 Key Laboratory of Molecular Cardiology, Xi'an Jiaotong University, Xi'an, China
3 Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University Ministry of Education, Xi'an, China
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    Figure 1

    Kaplan-Meier analysis of MACEs based on the ApoA-I levels. The 294 patients were divided by tertiles of the ApoA-I levels: 0.99, 0.99–1.14, and >1.14 g/L. Risk of a MACE increased with decreasing tertile of the ApoA-I levels (log-rank test 33.354, p<0.001). ApoA-I, apolipoprotein A-I; MACE, major adverse cardiovascular event.

Tables

  • Figures
  • Table 1

    Baseline characteristics of the first group

    CharacteristicsGrouped by LVEF (%)P valueGrouped by log NT-proBNP (pg/mL)P value
    <40 (n=47)40–50 (n=79)>50 (n=377)<6.82 (n=140)6.82–9.06 (n=142)>9.06 (n=139)
    Age (years)66.21±12.7166.58±12.8866.46±11.94ns68.07±12.2366.13±11.2365.09±13.33ns
    Male, n (%)36 (76.60)61 (77.22)245 (64.99)ns86 (61.42)99 (69.71)104 (74.82)ns
    Height (cm)171.39±5.74169.13±5.94168.88±7.40ns168.41±7.461168.46±7.59170.58±5.59ns
    Weight (kg)74.30±9.7471.22±10.4469.20±10.75ns67.32±10.7669.59±11.1973.10±9.52<0.05
    Heart rate (beats/min)84.43±19.9277.19±16.0672.86±12.26<0.00171.37±9.5473.14±13.9178.26±17.36<0.001
    ALT (U/L)49.61 (18.85–37.50)53.25 (24.00–75.20)29.94 (18.00–36.00)ns27.41 (17.25–32.00)29.27 (19.00–34.00)42.72 (21.00–46.00)<0.05
    AST (U/L)113.48 (23.45–83.25)165.91 (37.00–293.60)54.24 (21.00–50.50)ns37.54 (20.50–27.50)76.35 (21.50–71.75)89.42 (24.00–113.00)<0.05
    BUN (mmol/L)11.19 (5.46–15.58)5.20 (4.10–6.45)5.44 (4.15–6.71)ns4.98 (3.83–6.21)5.75 (4.43–6.79)6.03 (4.44–6.79)ns
    Creatine (µmol/L)167.71 (81.70–163.50)82.57 (63.00–97.00)82.75 (69.90–92.75)ns77.80 (67.00–89.20)87.89 (73.75–94.95)96.12 (75.60–101.00)<0.001
    UA (µmol/L)411.47 (337.75–397.03)322.89 (264.48–403.97)323.92 (258.64–386.10)ns305.34 (251.27–367.80)326.44 (245.53–403.67)329.70 (272.30–369.20)ns
    Serum lipid profile
     TG (mmol/L)1.37±0.711.78±1.291.78±1.17ns1.90±1.341.81±1.181.45±0.81<0.05
     TC (mmol/L)3.80±1.144.02±0.873.93±0.92ns3.97±0.873.91±0.923.97±1.01ns
     HDL-C (mmol/L)0.90±0.270.93±0.220.95±0.54ns0.96±0.230.93±0.250.95±0.24ns
     LDL-C (mmol/L)2.73±3.262.43±0.712.35±0.77ns2.36±0.702.35±0.782.40±0.85ns
     non-HDL (mmol/L)3.75±5.764.37±11.372.94±0.98ns3.00±0.792.96±0.883.02±0.94ns
     LDL/HDL2.82±1.762.72±0.982.56±1.02ns2.52±0.792.62±1.012.63±1.07ns
     ApoA-I (g/L)1.02±0.241.04±0.171.11±0.19<0.051.11±0.181.10±0.191.04±0.20<0.05
     HDL/ApoA-I (mmol/g)0.88±0.130.89±0.130.85±0.15ns0.86±0.190.84±0.120.90±0.12<0.05
    • Data are mean±SD and number (%).

    • ALT, alanine aminotransferase; ApoA-I, apolipoprotein A-I; ApoA-I, apolipoprotein A-I; AST, aspartate aminotransferase; BUN, blood urea nitrogen; HDL, high-density lipoprotein; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; LVEF, left ventricular ejection fraction; ns, not significant; NT-proBNP, N-terminal pro-B-type natriuretic peptide; TC, total cholesterol; TG, triglyceride; UA, uric acid.

  • Table 2

    Correlation between serum lipid profile and cardiac function in patients with acute myocardial infarction in the first group

    CharacteristicsLVEFLog NT-proBNP
    Pearson correlationSig. (two-tailed)NPearson correlationSig. (two-tailed)N
    TG (mmol/L)0.088ns471−0.171<0.05402
    TC (mmol/L)−0.023ns469−0.02ns399
    HDL-C (mmol/L)0.081ns470−0.037ns401
    LDL-C (mmol/L)−0.031ns4700.008ns401
    Non-HDL (mmol/L)−0.051ns467−0.009ns398
    LDL/HDL−0.07ns4700.04ns401
    ApoA-I (g/L)0.165<0.001469−0.181<0.001400
    HDL-C/ApoA-I (mmol/g)0.039ns4710.14<0.05400
    • ApoA-I, apolipoprotein A-I; ApoA-I, apolipoprotein A-I; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; LVEF, left ventricular ejection fraction; ns, not significant; NT-proBNP, N-terminal pro-B-type natriuretic peptide; TC, total cholesterol; TG, triglyceride.

  • Table 3

    Baseline characteristics of the second group

    CharacteristicsGrouped by LVEF (%)P valueGrouped by log NT-proBNP (pg/mL)P value
    <40 (n=23)40–50 (n=58)>50 (n=193)<7.51 (n=95)7.51–9.58 (n=91)>9.58 (n=93)
    Age (years)59.52±12.1462.48±11.8659.93±10.18ns57.84±10.4660.47±9.7363.34±11.70ns
    Male, n (%)22 (95.65)49 (84.48)141 (73.05)ns68 (71.57)67 (73.62)80 (86.02)ns
    Height (cm)171.44±6.60169.10±7.63167.80±7.16ns168.43±7.67168.33±7.09168.40±7.22ns
    Weight (kg)74.03±11.2572.54±10.4770.39±11.45ns71.37±11.2771.36±12.2370.06±10.70ns
    Heart rate (beats/min)80.13±17.9671.45±13.3669.05±11.45<0.00168.49±11.9068.67±10.8174.62±14.60<0.001
    ALT (U/L)38.71 (18.65–52.50)43.99 (20.05–51.50)36.52 (20.05–51.50)ns36.35 (17.00–38.80)37.71 (17.94–50.30)39.14 (16.90–52.50)ns
    AST (U/L)77.09 (18.30–61.62)90.32 (20.07–123.05)48.69 (18.57–57.28)<0.0541.65 (17.34–36.61)54.35 (20.54–62.33)77.36 (19.89–103.46)<0.001
    BUN (mmol/L)5.42 (4.30–6.37)5.43 (4.45–6.05)4.64 (3.69–5.34)<0.0014.69 (3.90–5.36)4.83 (3.80–5.49)5.24 (4.05–5.93)<0.05
    Creatine (µmol/L)76.68 (63.17–81.05)78.29 (64.05–85.73)66.43 (57.16–74.18)<0.0564.80 (57.94–71.36)67.49 (56.92–76.32)76.81 (62.00–82.07)<0.05
    UA (µmol/L)351.34 (277.55–414.69)318.94 (261.01–380.00)311.31 (255.64–349.03)<0.05315.48 (252.16–352.48)306.18 (248.97–348.78)325.11 (266.83–375.34)ns
    Serum lipid profile
     TG (mmol/L)1.60±1.451.46±0.871.66±0.89ns1.77±0.901.74±1.161.36±0.69ns
     TC (mmol/L)4.02±1.043.51±0.893.82±0.80ns3.77±0.813.71±0.803.88±1.00ns
     HDL-C (mmol/L)0.88±0.260.91±0.240.92±0.21ns0.93±0.240.92±0.200.88±0.23ns
     LDL-C (mmol/L)2.23±0.952.02±0.732.30±0.81ns2.25±0.772.30±0.842.13±0.84ns
     Non-HDL (mmol/L)3.10±0.982.63±0.822.90±0.76ns2.82±0.792.80±0.762.97±0.93ns
     LDL/HDL2.60±0.902.31±0.892.60±1.02ns2.56±1.072.55±0.892.51±1.03ns
     ApoA-I (g/L)1.00±0.231.06±0.201.08±0.18ns1.11±0.201.08±0.161.00±0.19<0.001
     HDL/ApoA-I (mmol/g)0.87±0.120.86±0.110.84±0.10ns0.83±0.960.84±0.100.87±0.11<0.05
    • Data are mean±SD and number (%).

    • ALT, alanine aminotransferase; ApoA-I, apolipoprotein A-I; ApoA-I, apolipoprotein A-I; AST, aspartate aminotransferase; BUN, blood urea nitrogen; HDL, high-density lipoprotein; HDL-C, high-density lipoprotein cholesterol; LDL, low-density lipoprotein; LDL-C, low-density lipoprotein cholesterol; LVEF, left ventricular ejection fraction; ns, not significant; NT-proBNP, N-terminal pro-B-type natriuretic peptide; TC, total cholesterol; TG, triglyceride; UA, uric acid.

  • Table 4

    Correlation between serum lipid profile and cardiac function in patients with acute myocardial infarction in the second group

    CharacteristicsLVEFLog NT-proBNP
    Pearson correlationSig. (two-tailed)NPearson correlationSig. (two-tailed)N
    TG (mmol/L)0.035ns271−0.175<0.001277
    TC (mmol/L)0.093ns169−0.01ns165
    HDL-C (mmol/L)0.111ns271−0.085ns277
    LDL-C (mmol/L)0.100ns271−0.08ns277
    Non-HDL (mmol/L)0.076ns1690.01ns165
    LDL/HDL0.036ns271−0.03ns277
    ApoA-I (g/L)0.165<0.05271−0.23<0.001277
    HDL-C/ApoA-I (mmol/g)−0.028ns2710.181<0.05277
    • ApoA-I, apolipoprotein A-I; ApoA-I, apolipoprotein A-I; HDL, high-density lipoprotein; HDL-C, high-density lipoprotein cholesterol; LDL, low-density lipoprotein; LDL-C, low-density lipoprotein cholesterol; LVEF, left ventricular ejection fraction; ns, not significant; NT-proBNP, N-terminal pro-B-type natriuretic peptide; TC, total cholesterol; TG, triglyceride.

  • Table 5

    Univariate and multivariate Cox analysis for MACEs in the second group

    VariableUnivariate analysisMultivariate analysis
    HR95% CIP valueHR95% CIP value
    ApoA-I levels
     High (>1.14 g/L)ReferenceReference
     Middle (0.99–1.14 g/L)1.4840.713 to 3.0910.2911.7340.649 to 4.6310.272
     Low (<0.99 g/L)2.2941.239 to 4.2480.0083.4111.373 to 8.6650.008
    • Adjusted for age, sex, height, weight, creatinine, left ventricular ejection fraction, and N-terminal pro-B-type natriuretic peptide.

    • ApoA-I, apolipoprotein A-I; 95 % CI, 95 % confidence interval; HR, hazard ratio; MACE, major adverse cardiovascular event.

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Circulating lipid and lipoprotein profiles and their correlation to cardiac function and cardiovascular outcomes in patients with acute myocardial infarction
Haoyu Wu, Chen Wang, Gulinigaer Tuerhongjiang, Xiangrui Qiao, Yiming Hua, Jianqing She, Zuyi Yuan
Journal of Investigative Medicine Oct 2021, 69 (7) 1310-1317; DOI: 10.1136/jim-2021-001803

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Circulating lipid and lipoprotein profiles and their correlation to cardiac function and cardiovascular outcomes in patients with acute myocardial infarction
Haoyu Wu, Chen Wang, Gulinigaer Tuerhongjiang, Xiangrui Qiao, Yiming Hua, Jianqing She, Zuyi Yuan
Journal of Investigative Medicine Oct 2021, 69 (7) 1310-1317; DOI: 10.1136/jim-2021-001803
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Circulating lipid and lipoprotein profiles and their correlation to cardiac function and cardiovascular outcomes in patients with acute myocardial infarction
Haoyu Wu, Chen Wang, Gulinigaer Tuerhongjiang, Xiangrui Qiao, Yiming Hua, Jianqing She, Zuyi Yuan
Journal of Investigative Medicine Oct 2021, 69 (7) 1310-1317; DOI: 10.1136/jim-2021-001803
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