Xu Feng, Lv Shuzheng, Chen Yundai, Song Xiantao, Jin Zening, Yuan Fei, Zhou Yuan, Li Hong
Beijing Anzhen Hospital, Capital Medical University, 2 Anzhen Road, Beijing, China.
Cardiology. 2012;121(1):12-9. doi: 10.1159/000335886. Epub 2012 Feb 24.
We tested the hypothesis that the plasma levels of fibrinogen and macrophage inflammatory protein (MIP)-1β are synergistic predictive markers of the prognosis of intermediate coronary artery lesions.
A prospective study was performed on 670 patients with intermediate coronary artery lesions. Fibrinogen and MIP-1β were measured. Major adverse cardiac event (MACE) was defined as a composite of cardiovascular death, nonfatal myocardial infarction, revascularization and readmission due to angina pectoris.
During follow-up, 72 events occurred; 5 patients died, 7 patients suffered a nonfatal myocardial infarction, 11 patients underwent revascularization and 49 patients were readmitted for angina pectoris. In patients with above-median levels of MIP-1β, a 2.62-fold risk of a MACE [95% confidence interval (CI) 1.53-4.48] was predicted compared with patients with below-median levels of MIP-1β. However, the strongest risk prediction was achieved by assessing MIP-1β and fibrinogen together. After adjusting for traditional risk factors, a multivariate Cox proportional hazards analysis showed that patients with both MIP-1β and fibrinogen above the median had a 4.37-fold risk of a MACE (95% CI 1.89-10.11).
MIP-1β accurately predicted MACEs. Considering MIP-1β and fibrinogen together may improve long-term risk assessment. These two biomarkers have a synergistic effect for assessing long-term risk in patients with intermediate coronary artery lesions.
我们检验了以下假设，即纤维蛋白原和巨噬细胞炎性蛋白（MIP）-1β的血浆水平是冠状动脉中度病变预后的协同预测指标。
对670例冠状动脉中度病变患者进行了一项前瞻性研究。检测了纤维蛋白原和MIP-1β。主要不良心脏事件（MACE）定义为心血管死亡、非致死性心肌梗死、血运重建和因心绞痛再次入院的综合情况。
在随访期间，发生了72起事件；5例患者死亡，7例患者发生非致死性心肌梗死，11例患者接受了血运重建，49例患者因心绞痛再次入院。与MIP-1β水平低于中位数的患者相比，MIP-1β水平高于中位数的患者发生MACE的风险预测值为2.62倍[95%置信区间（CI）1.53 - 4.48]。然而，通过同时评估MIP-1β和纤维蛋白原可实现最强的风险预测。在对传统风险因素进行校正后，多变量Cox比例风险分析显示，MIP-1β和纤维蛋白原均高于中位数的患者发生MACE的风险为4.37倍（95% CI 1.89 - 10.11）。
MIP-1β能准确预测MACE。同时考虑MIP-1β和纤维蛋白原可能会改善长期风险评估。这两种生物标志物在评估冠状动脉中度病变患者的长期风险方面具有协同作用。
