Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Laboratory of Immunology and Infectious Diseases, Graduate School of Medical Science and Engineering, KAIST, Daejeon, Republic of Korea.
Laboratory of Immunology and Infectious Diseases, Graduate School of Medical Science and Engineering, KAIST, Daejeon, Republic of Korea.
PLoS One. 2014 May 6;9(5):e96538. doi: 10.1371/journal.pone.0096538. eCollection 2014.
Inflammation plays a key role in the pathogenesis of acute myocardial infarction (MI). However, it is unclear whether marker of immune activation will provide prognostic information in these patients. We hypothesized that circulating levels of soluble CD93 (sCD93), a soluble form of transmembrane glycoprotein CD93, is increased in acute MI patients and its level would be associated with clinical outcomes in patients with acute MI.
We measured circulating levels of sCD93 in 120 patients with acute MI (63±13 yrs, M∶F = 85∶35) and in 120 age, sex-matched control subjects. In patients with acute MI, clinical characteristics, echocardiographic and laboratory findings were assessed at the time of initial enrollment. The primary outcome was defined as all-cause and cardiovascular death.
Circulating sCD93 levels were significantly higher in patients with acute MI than in control subjects (552.1±293.7 vs. 429.8±114.2 ng/mL, p<0.0001). Upon in vitro inflammatory stimulation, increased CD93 shedding was demonstrated in acute MI patients but not in control subjects. During follow up period (median 208 days, 3-1058 days), the primary outcome occurred in 18 (15%) patients (9 cardiovascular deaths). Circulating levels of sCD93 were associated with all cause (p<0.0001) and cardiovascular (p<0.0001) mortality in patients with acute MI. Multivariate Cox regression analysis revealed that initial sCD93 level was found to be an independent predictor of all cause (p = 0.002) and cardiovascular mortality (p = 0.033) when controlled for age and left ventricular ejection fraction.
Circulating levels of sCD93 are elevated in patients with acute MI and their levels were associated with adverse clinical outcomes.
炎症在急性心肌梗死（MI）的发病机制中起关键作用。然而，目前尚不清楚免疫激活标志物是否会为这些患者提供预后信息。我们假设循环可溶性 CD93（sCD93）水平在急性 MI 患者中升高，其水平与急性 MI 患者的临床结局相关。
我们测量了 120 例急性 MI 患者（63±13 岁，M∶F=85∶35）和 120 例年龄、性别匹配的对照者的循环 sCD93 水平。在急性 MI 患者中，在初始入组时评估了临床特征、超声心动图和实验室检查结果。主要结局定义为全因和心血管死亡。
与对照组相比，急性 MI 患者的循环 sCD93 水平明显升高（552.1±293.7 vs. 429.8±114.2 ng/mL，p<0.0001）。在体外炎症刺激下，急性 MI 患者的 CD93 脱落增加，但对照组没有。在随访期间（中位数 208 天，3-1058 天），18 例（15%）患者发生主要结局（9 例心血管死亡）。循环 sCD93 水平与急性 MI 患者的全因（p<0.0001）和心血管（p<0.0001）死亡率相关。多变量 Cox 回归分析显示，在校正年龄和左心室射血分数后，初始 sCD93 水平是全因（p=0.002）和心血管死亡率（p=0.033）的独立预测因子。
循环 sCD93 水平在急性 MI 患者中升高，其水平与不良临床结局相关。
