Cavusoglu Erdal, Chopra Vineet, Gupta Amit, Ruwende Cyril, Yanamadala Sunitha, Eng Calvin, Clark Luther T, Pinsky David J, Marmur Jonathan D
Department of Medicine, State University of New York Downstate Medical Center, Brooklyn, New York, USA.
Am J Cardiol. 2006 Nov 1;98(9):1189-93. doi: 10.1016/j.amjcard.2006.05.048. Epub 2006 Sep 7.
There are limited data about the relative importance of the many different but inter-related inflammatory markers with respect to their ability to independently predict the presence and extent of coronary artery disease (CAD). In addition, studies demonstrating such associations have often been conducted in well-defined populations and have excluded patients with or not adjusted for co-morbidities associated with CAD. In a cohort of 389 men who underwent coronary angiography for a variety of clinical indications and across a spectrum of risk, the following inflammatory markers were measured at baseline to determine their relative abilities to predict angiographic outcomes: C-reactive protein, myeloperoxidase, tissue inhibitor of metalloproteinase-1, erythrocyte sedimentation rate, and white blood cell (WBC) count. This analysis was done in the context of traditional CAD risk factors and other co-morbidities associated with CAD (such as morbid obesity, renal dysfunction, heart failure, and so forth). WBC count was the only marker that was independently associated with angiographically documented CAD (p = 0.0184). Further, WBC count (odds ratio 1.31, 95% confidence interval 1.05 to 1.64, p = 0.0157) and plasma myeloperoxidase (odds ratio 1.35, 95% confidence interval 1.08 to 1.69, p = 0.0090) were the only inflammatory markers that were independently predictive of the presence of multivessel disease on coronary angiography. In conclusion, these data demonstrate that a simple baseline WBC count is independently associated with angiographic CAD, and that it can predict the presence of multivessel disease, even in the context of clinical CAD risk factors and other established inflammatory markers.
关于许多不同但相互关联的炎症标志物在独立预测冠状动脉疾病（CAD）的存在和程度方面的相对重要性，相关数据有限。此外，证明此类关联的研究通常是在定义明确的人群中进行的，并且排除了患有与CAD相关的合并症或未对其进行调整的患者。在一组389名因各种临床指征接受冠状动脉造影且风险范围广泛的男性中，在基线时测量了以下炎症标志物，以确定它们预测血管造影结果的相对能力：C反应蛋白、髓过氧化物酶、金属蛋白酶组织抑制剂-1、红细胞沉降率和白细胞（WBC）计数。该分析是在传统CAD危险因素以及与CAD相关的其他合并症（如病态肥胖、肾功能不全、心力衰竭等）的背景下进行的。白细胞计数是唯一与血管造影记录的CAD独立相关的标志物（p = 0.0184）。此外，白细胞计数（优势比1.31，95%置信区间1.05至1.64，p = 0.0157）和血浆髓过氧化物酶（优势比1.35，95%置信区间1.08至1.69，p = 0.0090）是仅有的独立预测冠状动脉造影多支血管病变存在的炎症标志物。总之，这些数据表明，简单的基线白细胞计数与血管造影CAD独立相关，并且即使在存在临床CAD危险因素和其他既定炎症标志物的情况下，它也能预测多支血管病变的存在。
