Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
J Card Fail. 2010 Apr;16(4):308-13. doi: 10.1016/j.cardfail.2009.12.014. Epub 2010 Feb 26.
Midkine, a heparin-binding growth factor, has various functions such as migration of inflammatory cell and anti-apoptotic effect. Invasion of inflammatory cell and cardiomyocyte apoptosis are involved in development and progression of heart failure (HF). However, the relationship between midkine and HF has not been previously examined. Therefore, we examined clinical significance of serum midkine levels to determine the prognosis of HF patients.
Serum levels of midkine were measured at admission in 216 consecutive patients hospitalized for HF and 60 control subjects. Patients were prospectively followed during a mean follow-up period of 653 +/- 375 days with the end points of cardiac death and progressive HF requiring rehospitalization. Serum concentrations of midkine were significantly higher in patients with HF than in controls. Patients with cardiac events had significantly higher concentrations of midkine than those without cardiac events. Kaplan-Meier analysis revealed that cardiac event rates increased markedly as midkine levels rose. Furthermore in the multivariate analysis, after adjustment for age, gender ,and complications, midkine was the independent predictor of cardiac events.
Serum midkine levels are increased in HF patients, and midkine is a novel marker for risk stratifying HF patients.
中期因子（midkine）是一种肝素结合生长因子，具有迁移炎性细胞和抗细胞凋亡等多种功能。炎性细胞浸润和心肌细胞凋亡参与心力衰竭（HF）的发生和发展。然而，midkine 与 HF 之间的关系尚未被研究。因此，我们检测了血清 midkine 水平的临床意义，以确定 HF 患者的预后。
在 216 例连续住院 HF 患者和 60 例对照者入院时测定血清 midkine 水平。平均随访 653±375 天，终点为心脏死亡和需要再住院的进行性 HF。HF 患者的血清 midkine 浓度明显高于对照组。有心脏事件的患者 midkine 浓度明显高于无心脏事件的患者。Kaplan-Meier 分析显示，随着 midkine 水平的升高，心脏事件发生率显著增加。此外，在多变量分析中，调整年龄、性别和并发症后，midkine 是心脏事件的独立预测因子。
HF 患者的血清 midkine 水平升高，midkine 是 HF 患者危险分层的新标志物。
