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接受直接血管成形术的急性心肌梗死患者炎症标志物与新发心血管事件之间的关系。

Relationship between inflammatory markers and new cardiovascular events in patients with acute myocardial infarction who underwent primary angioplasty.

作者信息

La Franca Eluisa, Caruso Marco, Sansone Angela, Iacona Rosanna, Ajello Laura, Mancuso Dario, Castellano Fabiana, Novo Salvatore, Assennato Pasquale

机构信息

Policlinico Universitario, Palermo, Italy.

出版信息

Glob J Health Sci. 2013 Mar 20;5(4):48-54. doi: 10.5539/gjhs.v5n4p48.

Abstract

INTRODUCTION

The determination of inflammation markers in circulation has enabled an important improvement in the study of cardiovascular diseases. It was tested the hypothesis that non-specific markers such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and fibrinogen may provide prognostic information in patients with acute myocardial infarction with persistent ST-segment elevation (STEMI) undergoing primary angioplasty (PCI).

PATIENTS

A cohort of 197 consecutive patients with STEMI undergoing primary PCI was enrolled, evaluating during hospitalization, the peak values of the following markers of inflammation: ESR, CRP and fibrinogen. A telephone follow-up has been made in order to investigate any possible new cardiovascular events after hospital discharge and the procedure performed.

RESULTS

Higher values of CRP were statistically associated with adverse future events as composite endpoint and with the single endpoint of death. Furthermore, higher age, presence of hypertension, history of previous cardiovascular events, were statistically significantly associated with cardiac events at follow up. In this group were also overrepresented subjects with anterior myocardial infarction in the anterior localization and with an EF ? 35% at discharge.

CONCLUSIONS

CRP appears to be a predictor of future cardiovascular events, confirming that a pro-inflammatory state promotes the progression of atherosclerotic disease and its complications.

摘要

引言

循环中炎症标志物的测定使心血管疾病的研究有了重要进展。我们检验了这样一个假设,即红细胞沉降率(ESR)、C反应蛋白(CRP)和纤维蛋白原等非特异性标志物可能为接受直接经皮冠状动脉介入治疗(PCI)的持续性ST段抬高型急性心肌梗死(STEMI)患者提供预后信息。

患者

纳入了一组197例连续接受直接PCI的STEMI患者,在住院期间评估以下炎症标志物的峰值:ESR、CRP和纤维蛋白原。进行了电话随访,以调查出院后任何可能的新的心血管事件以及所实施的治疗。

结果

较高的CRP值在统计学上与作为复合终点的不良未来事件以及死亡单一终点相关。此外,较高的年龄、高血压的存在、既往心血管事件史在统计学上与随访时的心脏事件显著相关。在该组中,前壁心肌梗死位于前壁且出院时左心室射血分数(EF)≤35%的患者也占比较高。

结论

CRP似乎是未来心血管事件的一个预测指标,证实了促炎状态会促进动脉粥样硬化疾病及其并发症的进展。

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