经皮冠状动脉介入治疗患者血浆骨桥蛋白水平的预后意义

Prognostic significance of plasma osteopontin levels in patients undergoing percutaneous coronary intervention.

作者信息

Kato Ryuichi, Momiyama Yukihiko, Ohmori Reiko, Tanaka Nobukiyo, Taniguchi Hiroaki, Arakawa Koh, Nakamura Haruo, Ohsuzu Fumitaka

机构信息

First Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan.

出版信息

Circ J. 2009 Jan;73(1):152-7. doi: 10.1253/circj.cj-08-0687. Epub 2008 Nov 21.

DOI:10.1253/circj.cj-08-0687

PMID:19023151

Abstract

BACKGROUND

Osteopontin (OPN) mRNA is highly expressed in atherosclerotic plaques and plasma OPN levels are high in patients with coronary artery disease and in those with restenosis. OPN-overexpressing transgenic mice show markedly increased neointimal formation after arterial injury.

METHODS AND RESULTS

The prognostic significance of the preprocedural plasma OPN level was investigated in 130 patients undergoing percutaneous coronary intervention (PCI). Patients were followed up for restenosis and major adverse cardiovascular events (MACE). At 7+/-3 months after PCI, angiography was performed again in 91 patients, of whom 40 had restenosis. Between patients with and without restenosis, OPN (492+/-200 vs 482+/-224 ng/ml) and C-reactive protein (CRP: 0.78 vs 0.70 mg/L) levels did not differ. During a 3-year follow-up, MACE occurred in 21 patients, who had higher OPN (586+/-230 vs 438+/-195 ng/ml) and CRP (1.30 vs 0.70 mg/L) levels than those without MACE (P<0.005). Both OPN and CRP levels were independent predictors for MACE. Hazard ratios for MACE were 1.3 (95% confidence interval (CI) 1.1-1.5) for a 100 ng/ml increase in OPN and 3.6 (95%CI 1.4-9.3) for CRP >1.0 mg/L.

CONCLUSIONS

In patients undergoing PCI, the preprocedural OPN and CRP levels are independent predictors for further cardiovascular events, but not for restenosis.

摘要

背景

骨桥蛋白（OPN）mRNA在动脉粥样硬化斑块中高表达，冠心病患者和再狭窄患者的血浆OPN水平升高。过表达OPN的转基因小鼠在动脉损伤后显示出新内膜形成明显增加。

方法与结果

在130例接受经皮冠状动脉介入治疗（PCI）的患者中研究了术前血浆OPN水平的预后意义。对患者进行再狭窄和主要不良心血管事件（MACE）的随访。PCI术后7±3个月，91例患者再次进行血管造影，其中40例发生再狭窄。有再狭窄和无再狭窄的患者之间，OPN（492±200 vs 482±224 ng/ml）和C反应蛋白（CRP：0.78 vs 0.70 mg/L）水平无差异。在3年的随访期间，21例患者发生了MACE，这些患者的OPN（586±230 vs 438±195 ng/ml）和CRP（1.30 vs 0.70 mg/L）水平高于未发生MACE的患者（P<0.005）。OPN和CRP水平都是MACE的独立预测因子。OPN每增加100 ng/ml，MACE的风险比为1.3（95%置信区间（CI）1.1-1.5），CRP>1.0 mg/L时为3.6（95%CI 1.4-9.3）。