Yeşilay Asuman Biçer, Karakurt Ozlem, Akdemir Ramazan, Erden Gönül, Kılıç Harun, Açıkel Sadık, Karasu Betül, Sarı Münevver, Balcı Mustafa, Aksoy Murat
Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
Turk Kardiyol Dern Ars. 2011 Dec;39(8):654-60. doi: 10.5543/tkda.2011.01751.
Thymosin beta4 (Tβ4) has been shown to have an important role in healing of damaged tissues and promoting cardiomyocyte survival in acute coronary syndromes. We evaluated endogenous Tβ4 levels in patients presenting with ST-elevation acute myocardial infarction (STEMI) before and after successful primary percutaneous coronary intervention (PCI).
The study included 24 consecutive patients (7 females, 17 males; mean age 55.0±10.9 years) who underwent successful primary PCI for STEMI and 24 age- and sex-matched healthy controls (13 females, 11 males; mean age 57.5±11.7 years) with angiographically normal coronary arteries. To determine Tβ4 levels, blood samples were obtained from STEMI patients on admission and 48 hours after successful PCI, and from controls immediately after coronary angiography.
Compared to controls, baseline levels of high-density lipoprotein cholesterol (46.2±8.9 vs. 34.2±7.2 mg/dl, p<0.001) and Tβ4 (2.9±1.5 vs. 1.5±1.0 µg/ml, p<0.001) were significantly lower, and white blood cell counts (7.6±2.2 vs. 11.4±3.0 10³/µl, p<0.001) were significantly higher in the STEMI group. After 48 hours of PCI, the mean Tβ4 level increased significantly to 2.3±0.8 µg/ml (p<0.001) and became similar to that of the control group (p=0.068). There was a significant negative correlation between serum Tβ4 and white blood cell count (r=-0.347, p=0.016).
Considering the significant increase in serum Tβ4 levels following successful primary PCI in patients with STEMI, Tβ4 may prove to be a new marker in the assessment of reperfusion success in addition to those used currently.
胸腺素β4(Tβ4)已被证明在受损组织愈合及促进急性冠状动脉综合征中心肌细胞存活方面发挥重要作用。我们评估了ST段抬高型急性心肌梗死(STEMI)患者在成功进行直接经皮冠状动脉介入治疗(PCI)前后的内源性Tβ4水平。
该研究纳入了24例连续接受STEMI直接PCI治疗且治疗成功的患者(7例女性,17例男性;平均年龄55.0±10.9岁)以及24例年龄和性别匹配的健康对照者(13例女性,11例男性;平均年龄57.5±11.7岁),后者冠状动脉造影显示正常。为测定Tβ4水平,在STEMI患者入院时及PCI成功后48小时采集血样,在冠状动脉造影后立即从对照者采集血样。
与对照组相比,STEMI组的高密度脂蛋白胆固醇基线水平(46.2±8.9 vs. 34.2±7.2 mg/dl,p<0.001)和Tβ4水平(2.9±1.5 vs. 1.5±1.0 μg/ml,p<0.001)显著更低,而白细胞计数(7.6±2.2 vs. 11.4±3.0×10³/μl,p<0.001)显著更高。PCI术后48小时,平均Tβ4水平显著升高至2.3±0.8 μg/ml(p<其<0.001),并与对照组水平相似(p=0.068)。血清Tβ4与白细胞计数之间存在显著负相关(r=-0.347,p=0.016)。
鉴于STEMI患者成功进行直接PCI后血清Tβ4水平显著升高,Tβ4可能被证明是除目前使用的指标之外评估再灌注成功的一个新标志物。