Zhang Ya-chen, Tang Yong, Chen Yu, Huang Xiao-hong, Zhang Min, Chen Jian, Sun Ying-gang, Li Yi-gang
Division of Cardiology, Xinhua Hospital School of Medicine, Shanghai Jiaotong University, 1665 Kong Jiang Road, Shanghai, 200092, China,
Cell Biochem Biophys. 2014 Mar;68(2):379-85. doi: 10.1007/s12013-013-9718-1.
It has been shown that the elevated concentrations of oxidized low-density lipoprotein (Ox-LDL) or high-sensitivity C-reactive protein (hs-CRP) are predictive of future cardiovascular events for acute coronary syndrome (ACS) patients. But, the combined value of Ox-LDL and hs-CRP for predicting cardiovascular events is still unknown. Serum concentrations of Ox-LDL, hs-CRP, and cTnT were measured in a prospective cohort of 425 selective ACS patients followed 3-5 years for the occurrence of acute myocardial infarction (AMI) or death (AMI/death). Among 425 enrolled patients, 124 patients demonstrated AMI/death. Baseline levels of Ox-LDL, hs-CRP, and cTnT were significantly higher in AMI/death group than the event-free survival group. Kaplan-Meier survival analyses supported that elevations in Ox-LDL or hs-CRP predicted increased cardiovascular events risks. However, the strongest risk prediction was achieved by assessing Ox-LDL and hs-CRP together. Patients with high levels of Ox-LDL and hs-CRP were more likely to experience AMI or death than those with either Ox-LDL or hs-CRP elevated. Receiver-operating characteristic curves showed that Ox-LDL and hs-CRP have higher sensitivity and specificity than those of cTnT for predicting AMI or death. This was reflected by the AUC values for Ox-LDL, hs-CRP, and cTnT, which were 0.891, 0.834, and 0.626, respectively. The combined use of Ox-LDL and hs-CRP may improve prognosis after ACS with high-sensitivity and specificity.
研究表明,氧化型低密度脂蛋白(Ox-LDL)或高敏C反应蛋白(hs-CRP)浓度升高可预测急性冠状动脉综合征(ACS)患者未来发生心血管事件。但是,Ox-LDL和hs-CRP联合预测心血管事件的价值仍不清楚。对425例选择性ACS患者的前瞻性队列进行了研究,检测其血清中Ox-LDL、hs-CRP和肌钙蛋白T(cTnT)的浓度,并随访3至5年,观察急性心肌梗死(AMI)或死亡(AMI/死亡)的发生情况。在425例入选患者中,124例发生了AMI/死亡。AMI/死亡组的Ox-LDL、hs-CRP和cTnT基线水平显著高于无事件生存组。Kaplan-Meier生存分析支持Ox-LDL或hs-CRP升高可预测心血管事件风险增加。然而,通过同时评估Ox-LDL和hs-CRP可实现最强的风险预测。与Ox-LDL或hs-CRP单独升高的患者相比,Ox-LDL和hs-CRP水平均高的患者更易发生AMI或死亡。受试者工作特征曲线显示,在预测AMI或死亡方面,Ox-LDL和hs-CRP比cTnT具有更高的敏感性和特异性。这通过Ox-LDL、hs-CRP和cTnT的曲线下面积(AUC)值得到体现,分别为0.891、0.834和0.626。联合使用Ox-LDL和hs-CRP可能以高敏感性和特异性改善ACS后的预后。