Department of Cardiology, Elazig Education and Research Hospital, Elazig, Turkey.
J Thromb Thrombolysis. 2012 Nov;34(4):483-90. doi: 10.1007/s11239-012-0770-2.
Percutaneous coronary intervention-related periprocedural myocardial infarction (PCI-RPMI) has now been definitively linked in large data sets to long-term adverse outcomes. It is more likely that the relationship is caused by the underlying predisposing factors that led to the PCI-RPMI, such as plaque vulnerability. Lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) is involved in multiple phases of vascular dysfunction, including atherosclerotic plaque formation and/or vulnerability. The purpose of this study was to determine whether soluble LOX-1 (sLOX-1) is associated with myocardial necrosis in elective native single-vessel PCI (NSV-PCI). From January 2010 to January 2012, 214 consecutive stable patients undergoing elective NSV-PCI were enrolled. Troponin T, CK and CK-MB were performed to screen for PCI-induced myocardial necrosis after the procedure, and PCI-RPMI was defined as three times the ULN of CK, which was confirmed by the elevation of the CK-MB and troponin T. According to the cardiac biomarkers result, patients were divided into two groups [PCI-RPMI(+) and PCI-RPMI(-)]. sLOX-1 levels were measured in serum by ELISA. Of the 214 patients who underwent NSV-PCI, 33 (15.4 %) patients developed PCI-RPMI. The results of this study showed that among patients undergoing elective NSV-PCI, those with PCI-RPMI had significantly higher circulating sLOX-1 levels than those without (167 ± 89 vs. 99 ± 68 pg/mL; p < 0 0.001). There were high correlations between sLOX-1 levels and CK and CK-MB values (r = 0.677 and r = 0.682, respectively; p < 0.001). Our study demonstrated that circulating sLOX-1 levels were associated with PCI-RPMI, which might predict periprocedural myocardial necrosis in elective NSV-PCI. Importantly, the study speculates that the level of sLOX-1 may help to identify patients at risk for PCI-RPMI before the procedure. sLOX-1 may provide new insights into not only risk stratification, but also therapeutic strategies for elective PCI.
经皮冠状动脉介入治疗相关围手术期心肌梗死(PCI-RPMI)已在大量数据集中明确与长期不良结局相关。更有可能的是,这种关系是由导致 PCI-RPMI 的潜在诱发因素引起的,例如斑块易损性。凝集素样氧化低密度脂蛋白受体-1(LOX-1)参与血管功能障碍的多个阶段,包括动脉粥样硬化斑块形成和/或易损性。本研究旨在确定可溶性 LOX-1(sLOX-1)是否与择期原生单血管 PCI(NSV-PCI)中的心肌坏死有关。2010 年 1 月至 2012 年 1 月,连续纳入 214 例接受择期 NSV-PCI 的稳定患者。在手术后进行肌钙蛋白 T、CK 和 CK-MB 以筛查 PCI 诱导的心肌坏死,将 PCI-RPMI 定义为 CK 的三倍 ULN,这通过 CK-MB 和肌钙蛋白 T 的升高得到证实。根据心脏生物标志物的结果,患者分为两组[PCI-RPMI(+)和 PCI-RPMI(-)]。通过 ELISA 法测量血清中的 sLOX-1 水平。在接受 NSV-PCI 的 214 例患者中,33 例(15.4%)患者发生 PCI-RPMI。这项研究的结果表明,在接受择期 NSV-PCI 的患者中,发生 PCI-RPMI 的患者循环 sLOX-1 水平显著高于未发生 PCI-RPMI 的患者(167±89 与 99±68 pg/mL;p<0.001)。sLOX-1 水平与 CK 和 CK-MB 值之间存在高度相关性(r=0.677 和 r=0.682,分别;p<0.001)。我们的研究表明,循环 sLOX-1 水平与 PCI-RPMI 相关,可能预测择期 NSV-PCI 中的围手术期心肌坏死。重要的是,该研究推测,sLOX-1 水平可帮助识别术前发生 PCI-RPMI 的高危患者。sLOX-1 可能为择期 PCI 的风险分层和治疗策略提供新的见解。