可溶性 P 选择素水平与男性透析患者心血管死亡率和心源性猝死相关。
Soluble P-selectin levels are associated with cardiovascular mortality and sudden cardiac death in male dialysis patients.
机构信息
Department of Medicine, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
出版信息
Am J Nephrol. 2011;33(3):224-30. doi: 10.1159/000324517. Epub 2011 Feb 23.
BACKGROUND/AIMS: P-selectin is released by activated platelets and endothelium contributing to inflammation and thrombosis. We evaluated the association between soluble P-selectin and atherosclerotic cardiovascular disease (ASCVD) in dialysis patients.
METHODS
We measured soluble P-selectin in serum from 824 incident dialysis patients. Using Cox proportional hazards models, we modeled the association of P-selectin levels with ASCVD events, cardiovascular mortality and sudden cardiac death.
RESULTS
After adjustment for demographics, comorbidity and traditional cardiovascular risk factors, higher P-selectin levels were associated with increased risk of ASCVD and cardiovascular mortality among males (p = 0.02 and p = 0.01, respectively), but not females (p = 0.52 and p = 0.31, respectively; p interaction = 0.003), over a median of 38.2 months. Higher P-selectin was associated with a greater risk of sudden cardiac death among males (p = 0.05). The associations between increasing P-selectin and cardiovascular mortality as well as sudden cardiac death in males persisted after adjustment for C-reactive protein, interleukin-6, serum albumin and platelet count (p = 0.01 and p = 0.03, respectively). The risk for sudden cardiac death was more than 3 times greater for males in the highest tertile of soluble P-selectin compared with the lowest tertile after adjustment (HR: 3.19; 95% CI: 1.18 - 8.62; p = 0.02).
CONCLUSION
P-selectin is associated with ASCVD, cardiovascular mortality and sudden cardiac death among male dialysis patients.
背景/目的：P-选择素由激活的血小板和内皮细胞释放，有助于炎症和血栓形成。我们评估了可溶性 P-选择素与透析患者动脉粥样硬化性心血管疾病（ASCVD）之间的关系。
方法
我们测量了 824 例新发生透析患者血清中的可溶性 P-选择素。使用 Cox 比例风险模型，我们构建了 P-选择素水平与 ASCVD 事件、心血管死亡率和心源性猝死的关联模型。
结果
在校正人口统计学、合并症和传统心血管危险因素后，较高的 P-选择素水平与男性 ASCVD 和心血管死亡率风险增加相关（p = 0.02 和 p = 0.01，分别），但与女性无关（p = 0.52 和 p = 0.31，分别；p 交互作用 = 0.003），中位随访时间为 38.2 个月。较高的 P-选择素与男性心源性猝死风险增加相关（p = 0.05）。在校正 C 反应蛋白、白细胞介素-6、血清白蛋白和血小板计数后，男性 P-选择素升高与心血管死亡率和心源性猝死之间的关联仍然存在（p = 0.01 和 p = 0.03，分别）。在校正后，可溶性 P-选择素最高三分位的男性心源性猝死风险比最低三分位的风险增加了 3 倍以上（HR：3.19；95%CI：1.18-8.62；p = 0.02）。
结论
在男性透析患者中，P-选择素与 ASCVD、心血管死亡率和心源性猝死相关。
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