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药物洗脱支架植入后稳定型冠状动脉疾病患者血浆五聚体-3水平的预后价值

Prognostic value of plasma pentraxin-3 levels in patients with stable coronary artery disease after drug-eluting stent implantation.

作者信息

Haibo Liu, Xiaofang Guo, Chunming Wang, Jie Yuan, Guozhong Chen, Limei Zhang, Yong Cao, Yu Fang, Yingchun Bao, Wangjun Yu, Junbo Ge

机构信息

Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, China ; Department of Cardiology, Yinzhou People's Hospital Affiliated to Medical School of Ningbo University, Ningbo 315040, China.

Clinical Laboratory Center, Yinzhou People's Hospital Affiliated to Medical School of Ningbo University, Ningbo 315040, China.

出版信息

Mediators Inflamm. 2014;2014:963096. doi: 10.1155/2014/963096. Epub 2014 Nov 24.

Abstract

Pentraxin-3 (PTX3) is an inflammatory marker thought to be more specific to cardiovascular inflammation than C-reactive protein (CRP). Our aim was to assess the prognostic value of PTX3 in patients with stable coronary artery disease (CAD) after drug eluting stent (DES) implantation. Plasma PTX3 levels were measured before percutaneous coronary intervention (PCI) and at 24 h post-PCI in 596 consecutive patients with stable CAD. Patients were followed up for a median of 3 years (range 1-5) for major adverse cardiovascular events (MACEs). We found that the post-PCI plasma PTX3 levels were significantly higher at 24 h after PCI than pre-PCI, patients with MACEs had higher post-PCI PTX3 levels compared with MACEs-free patients, patients with higher post-PCI PTX3 levels (median > 4.384 ng/mL) had a higher risk for MACEs than those with PTX3 < 4.384 ng/mL, and post-PCI PTX3, cTnI, multiple stents, and age but not high-sensitivity CRP (hsCRP) were independently associated with the prevalence of MACEs after DES implantation. The present study shows that post-PCI PTX3 may be a more reliable inflammatory predictor of long-term MACEs in patients with stable CAD undergoing DES implantation than CRP. Measurement of post-PCI PTX3 levels could provide a rationale for risk stratification of patients with stable CAD after DES implantation.

摘要

五聚体蛋白3(PTX3)是一种炎症标志物,被认为比C反应蛋白(CRP)对心血管炎症更具特异性。我们的目的是评估PTX3在药物洗脱支架(DES)植入后稳定型冠状动脉疾病(CAD)患者中的预后价值。对596例连续的稳定型CAD患者在经皮冠状动脉介入治疗(PCI)前及PCI后24小时测量血浆PTX3水平。对患者进行了为期3年(范围1 - 5年)的主要不良心血管事件(MACE)随访。我们发现,PCI后24小时的血浆PTX3水平显著高于PCI前,发生MACE的患者与未发生MACE的患者相比,PCI后PTX3水平更高,PCI后PTX3水平较高(中位数> 4.384 ng/mL)的患者发生MACE的风险高于PTX3 < 4.384 ng/mL的患者,并且PCI后PTX3、肌钙蛋白I(cTnI)、多个支架和年龄而非高敏CRP(hsCRP)与DES植入后MACE的发生率独立相关。本研究表明,对于接受DES植入的稳定型CAD患者,PCI后PTX3可能是比CRP更可靠的长期MACE炎症预测指标。测量PCI后PTX3水平可为DES植入后稳定型CAD患者的风险分层提供依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a55/4265374/459bf6923af3/MI2014-963096.001.jpg

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