Tang Bei, Zhong Ze, Shen Hong-Wei, Wu Hui-Ping, Xiang Peng, Hu Bin
Department of Critical Care Medicine, The First People's Hospital of Jiande City, 599 Yanzhou Main Road, Jiande 311600, China.
Department of Critical Care Medicine, The First People's Hospital of Jiande City, 599 Yanzhou Main Road, Jiande 311600, China.
Peptides. 2014 Aug;58:98-102. doi: 10.1016/j.peptides.2014.06.009. Epub 2014 Jun 23.
Intermedin functions systemically as a potent vasodilator and its plasma levels have been shown to be elevated in patients with acute myocardial infarction. This study aimed to evaluate the prognostic value of plasma intermedin level in the patients with ST-segment elevation acute myocardial infarction. Plasma intermedin concentrations of 128 patients and 128 healthy controls were determined using a radioimmunoassay. Patients were followed up for 6 months for major adverse cardiovascular events (MACE) consisting of cardiovascular mortality, reinfarction, hospitalization for decompensated heart failure, and lift-threatening arrhythmia. The association of plasma intermedin levels with MACE was investigated by univariate and multivariate analyses. Plasma intermedin levels were significantly higher in patients than in healthy subjects. Elevated plasma level of intermedin was identified as an independent predictor of MACE. Receiver operating characteristic curve analysis showed that plasma intermedin levels had high predictive value for MACE. Moreover, its predictive value was similar to Global Registry of Acute Coronary Events scores' based on area under curve. Meantime, it obviously improved Global Registry of Acute Coronary Events scores' predictive value in a combined logistic-regression model. In multivariate Cox's proportional hazard analysis, plasma intermedin level emerged as an independent predictor of MACE-free survival. Thus, our results suggest that high plasma intermedin level is associated with poor outcomes of patients and may be a useful prognostic biomarker in ST-segment elevation acute myocardial infarction.
肾上腺髓质素作为一种强效血管舒张剂发挥全身作用，急性心肌梗死患者的血浆水平已被证明会升高。本研究旨在评估血浆肾上腺髓质素水平对ST段抬高型急性心肌梗死患者的预后价值。采用放射免疫分析法测定了128例患者和128例健康对照者的血浆肾上腺髓质素浓度。对患者进行了6个月的随访，观察主要不良心血管事件（MACE），包括心血管死亡、再梗死、因失代偿性心力衰竭住院以及危及生命的心律失常。通过单因素和多因素分析研究血浆肾上腺髓质素水平与MACE的相关性。患者的血浆肾上腺髓质素水平显著高于健康受试者。血浆肾上腺髓质素水平升高被确定为MACE的独立预测因子。受试者工作特征曲线分析表明，血浆肾上腺髓质素水平对MACE具有较高的预测价值。此外，其预测价值与基于曲线下面积的急性冠状动脉事件全球注册评分相似。同时，在联合逻辑回归模型中，它明显提高了急性冠状动脉事件全球注册评分的预测价值。在多因素Cox比例风险分析中，血浆肾上腺髓质素水平成为无MACE生存的独立预测因子。因此，我们的结果表明，血浆肾上腺髓质素水平升高与患者预后不良相关，可能是ST段抬高型急性心肌梗死中一种有用的预后生物标志物。
