Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway.
Int J Cardiol. 2013 Sep 30;168(2):1435-40. doi: 10.1016/j.ijcard.2012.12.090. Epub 2013 Jan 18.
Immune system activation is involved in atherosclerosis. Neopterin production and tryptophan catabolism through the kynurenine pathway, measured by the kynurenine-tryptophan ratio (KTR), are induced by interferon gamma, thus both are considered markers of cell mediated immune activation. This study prospectively investigated their predictive value on acute coronary events among Norwegian community-dwelling older adults without previous coronary heart disease.
1112 men and 1631 women, 71-74 years old were examined during 1997-99 as part of the Hordaland Health Study. They were followed until an acute coronary event (defined as unstable angina, non-fatal or fatal acute myocardial infarction or sudden death) or December 31, 2006. Kaplan-Meier hazard curves were constructed for quartiles of plasma neopterin and KTR. Cox proportional hazards models adjusted for sex, body mass index, smoking, hypertension, renal function and cholesterol were used to examine the relation between neopterin and KTR quartiles and the study endpoint.
Median (interquartile range) values were 8.6 (7.2-10.4) nmol/L for neopterin and 25.8 (25.3-31.1) nmol/μmol for KTR. During the follow up, 265 participants had at least one acute coronary event. Increased baseline levels of plasma neopterin and KTR were associated with continuous increased risk of developing the study endpoint (P-values for trend <0.001 and 0.019, respectively). Adjusted hazard ratios comparing the fourth quartile to the first were 1.65 (95% CI; 1.11-2.47; P=0.013) for neopterin and 1.57 (95% CI 1.03-2.39; P=0.036) for KTR.
Plasma neopterin and KTR levels predict acute coronary events in older adults without previous coronary heart disease.
免疫系统的激活与动脉粥样硬化有关。通过黄嘌呤途径，干扰素γ诱导新蝶呤的产生和色氨酸的分解代谢，通过黄嘌呤-色氨酸比（KTR）来衡量，这两者都被认为是细胞介导免疫激活的标志物。本研究前瞻性地调查了它们在挪威社区居住的无先前冠心病的老年人群中急性冠脉事件的预测价值。
1112 名男性和 1631 名女性，年龄在 71-74 岁，于 1997-99 年作为霍达兰健康研究的一部分进行了检查。他们随访至急性冠脉事件（定义为不稳定型心绞痛、非致死性或致死性急性心肌梗死或猝死）或 2006 年 12 月 31 日。为血浆新蝶呤和 KTR 的四分位数构建了 Kaplan-Meier 危险曲线。使用 Cox 比例风险模型，调整性别、体重指数、吸烟、高血压、肾功能和胆固醇，以检查新蝶呤和 KTR 四分位数与研究终点之间的关系。
中位数（四分位距）值分别为 8.6（7.2-10.4）nmol/L 的新蝶呤和 25.8（25.3-31.1）nmol/μmol 的 KTR。在随访期间，265 名参与者至少发生了一次急性冠脉事件。基线血浆新蝶呤和 KTR 水平升高与研究终点的发生风险连续增加相关（趋势 P 值 <0.001 和 0.019）。与第 1 四分位相比，第 4 四分位的调整后危险比分别为 1.65（95%可信区间 1.11-2.47；P=0.013）和 1.57（95%可信区间 1.03-2.39；P=0.036）。
无先前冠心病的老年人群中，血浆新蝶呤和 KTR 水平预测急性冠脉事件。
