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在首次行直接经皮冠状动脉介入治疗的急性心肌梗死患者中,半乳糖凝集素-3 与临床参数之间的相关性。

The association between galectin-3 and clinical parameters in patients with first acute myocardial infarction treated with primary percutaneous coronary angioplasty.

机构信息

Department of Internal Diseases and Cardiological Rehabilitation, Medical University of Lodz, Lodz, Poland.

出版信息

Cardiol J. 2013;20(6):577-82. doi: 10.5603/CJ.2013.0157.

Abstract

BACKGROUND

Galectin-3, a biomarker associated with fibrosis and inflammation, has been implicated in development and progression of heart failure (HF) and predicts increased mortality and morbidity in this condition. HF frequently develops after myocardial infarction (MI), contributing to worse outcome. The aim of this study is to assess the association between galectin-3 levels and various clinical parameters in acute phase of first MI treated with primary percutaneous coronary intervention (pPCI) in patients without prior HF.

METHODS

We included 145 consecutive patients with first acute MI treated with pPCI with stent implantation. Exclusion criteria were: prior HF, severe valvular diseases, coexisting cancers, connective tissue diseases and cirrhosis. Serum galectin-3 concentration was measured within 3-5 days after onset of acute MI.

RESULTS

Thirty-six patients with the highest galectin-3 levels (4th quartile, > 16 ng/mL) were compared to 109 subjects with a biomarker concentration ≤ 16 ng/mL. Elevated galectin-3 levels were more often observed in females, the elderly, subjects with coexisting diabetes, renaldysfunction and permanent atrial fi brillation (AF). Galectin-3 correlated with N-terminal pro-B-type natriuretic peptide (r = 0.27, p < 0.001) and high-sensitivity C-reactive protein (r = 0.20, p < 0.05). Multivariate analysis revealed that only new-onset AF and diuretics treatment during hospitalization were independently associated with galectin-3 levels > 16 ng/mL.

CONCLUSIONS

Elevated galectin-3 levels were associated with a higher rate of new-onset AF and diuretics treatment during hospitalization in patients with first MI treated with pPCI without prior HF.

摘要

背景

半乳糖凝集素-3(Galectin-3)是一种与纤维化和炎症相关的生物标志物,与心力衰竭(HF)的发生和进展有关,并可预测该疾病的死亡率和发病率增加。HF 常继发于心肌梗死(MI),导致预后更差。本研究旨在评估在无既往 HF 的接受直接经皮冠状动脉介入治疗(pPCI)的首次 MI 急性期患者中,Galectin-3 水平与各种临床参数的相关性。

方法

我们纳入了 145 例接受 pPCI 联合支架植入术治疗的首次急性 MI 连续患者。排除标准为:既往 HF、严重瓣膜疾病、并存癌症、结缔组织疾病和肝硬化。在急性 MI 发作后 3-5 天内测量血清 Galectin-3 浓度。

结果

将 Galectin-3 水平最高的 36 例患者(第 4 四分位数,>16ng/ml)与 Galectin-3 浓度≤16ng/ml 的 109 例患者进行比较。女性、老年人、并存糖尿病、肾功能不全和永久性心房颤动(AF)患者中更常观察到升高的 Galectin-3 水平。Galectin-3 与 N 末端脑利钠肽前体(NT-proBNP)(r=0.27,p<0.001)和高敏 C 反应蛋白(hs-CRP)(r=0.20,p<0.05)呈正相关。多变量分析显示,仅新发 AF 和住院期间使用利尿剂与 Galectin-3 水平>16ng/ml 独立相关。

结论

在无既往 HF 的接受 pPCI 治疗的首次 MI 患者中,Galectin-3 水平升高与新发 AF 和住院期间使用利尿剂的发生率更高相关。

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