Association between remnant cholesterol and progression of bioprosthetic valve degeneration

被引:2
作者
Li, Ziang [1 ,2 ]
Zhang, Bin [1 ,2 ]
Salaun, Erwan [1 ]
Cote, Nancy [1 ]
Mahjoub, Haifa [1 ]
Mathieu, Patrick [1 ]
Dahou, Abdelaziz [1 ]
Zenses, Anne-Sophie [1 ]
Xu, Yujun [3 ]
Pibarot, Philippe [1 ]
Wu, Yongjian [2 ]
Clavel, Marie-Annick [1 ]
机构
[1] Univ Laval, Quebec Heart & Lung Inst, Inst Univ Cardiol & Pneumol Quebec, Res Ctr, 2725 Chemin St Foy, Quebec City, PQ G1V 4G5, Canada
[2] Chinese Acad Med Sci & Peking Union Med Coll, Fuwai Hosp, Natl Ctr Cardiovasc Dis, State Key Lab Cardiovasc Dis,Dept Cardiol, Beijing 100037, Peoples R China
[3] Ludwig Maximilians Univ Munchen, Pettenkofer Sch Publ Hlth, Inst Med Informat Proc Biometry & Epidemiol, Munich, Germany
基金
加拿大健康研究院;
关键词
remnant cholesterol; bioprosthetic aortic valve; surgical aortic valve replacement; bioprosthetic valve degeneration; ATHEROSCLEROTIC CARDIOVASCULAR-DISEASE; DENSITY-LIPOPROTEIN CHOLESTEROL; TRIGLYCERIDE-RICH LIPOPROTEINS; OXIDIZED PHOSPHOLIPIDS; EUROPEAN ASSOCIATION; FASTER DEGENERATION; AMERICAN SOCIETY; LDL CHOLESTEROL; RESIDUAL RISK; CALCIFICATION;
D O I
10.1093/ehjci/jead159
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims Remnant cholesterol (RC) seems associated with native aortic stenosis. Bioprosthetic valve degeneration may share similar lipid-mediated pathways with aortic stenosis. We aimed to investigate the association of RC with the progression of bioprosthetic aortic valve degeneration and ensuing clinical outcomes. Methods and results We enrolled 203 patients with a median of 7.0 years (interquartile range: 5.1-9.2) after surgical aortic valve replacement. RC concentration was dichotomized by the top RC tertile (23.7 mg/dL). At 3-year follow-up, 121 patients underwent follow-up visit for the assessment of annualized change in aortic valve calcium density (AVCd). RC levels showed a curvilinear relationship with an annualized progression rate of AVCd, with increased progression rates when RC >23.7 mg/dL (P = 0.008). There were 99 deaths and 46 aortic valve re-interventions in 133 patients during a median clinical follow-up of 8.8 (8.7-9.6) years. RC >23.7 mg/dL was independently associated with mortality or re-intervention (hazard ratio: 1.98; 95% confidence interval: 1.31-2.99; P = 0.001). Conclusion Elevated RC is independently associated with faster progression of bioprosthetic valve degeneration and increased risk of all-cause mortality or aortic valve re-intervention.
引用
收藏
页码:1690 / 1699
页数:10
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