Прогностическое значение нетрадиционных параметров липидного обмена: индекса риска I по Кастелли, индекса риска II по Кастелли и отношения триглицеридов к холестерину липопротеинов высокой плотности у пациентов с инфарктом миокарда без подъема сегмента ST при годичном наблюдении

Цель    Концентрации классических липопротеинов имеют большое значение в неинвазивной кардиологии. Значение индекса риска Кастелли I (CRI I), индекса риска Кастелли II (CRI II) и отношения триглицеридов к холестерину липопротеинов высокой плотности (ТГ/ЛПВП) в клинической практике в настоящее время изучается. Целью настоящего исследования явилась оценка прогностической значимости CRI I, CRI II и ТГ/ЛПВП для частоты серьезных неблагоприятных сердечно-сосудистых событий (MACE) и смертности от всех причин в течение 1 года наблюдения за пациентами с инфарктом миокарда без подъема сегмента ST (ИМбпST).
Материалы и методы    В исследование был включен 1301 пациент. Изучены ассоциации между CRI I, CRI II, ТГ/ЛПВП и развитием MACE и 1-летней смертностью. Кроме того, оценивались корреляции между CRI I, CRI II и ТГ/ЛПВП и тяжестью ишемической болезни сердца (ИБС).
Результаты    MACE развился у 10,9% (142) пациентов, а годовая смертность составила 13,4% (174). Ни один из оцененных показателей не оказался независимым предиктором MACE ни во всей популяции, ни в субпопуляциях, разделенных в зависимости от наличия диабета или ИБС, диагностированных до госпитализации. Кроме этого, зависимости между годичной летальностью и исследуемыми показателями также не обнаружено. Наблюдалась лишь слабая корреляция между тяжестью ИБС и CRI I (R=0,08, p=0,02). Достоверных корреляций для CRI II (p=0,07) и ТГ/ЛПВП (p=0,6) выявлено не было.
Выводы    CRI I, CRI II и ТГ/ЛПВП не следует использовать в качестве предикторов MACE или смертности от всех причин среди пациентов с ИМбпST. Более того, эти показатели также не отражают тяжесть ИБС.

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