Higuma Takumi, Abe Naoki, Tateyama Syunta, Endo Tomohide, Shibutani Shuji, Yokoyama Hiroaki, Hanada Kenji, Yamada Masahiro, Tomita Hirofumi, Hanada Hiroyuki, Osanai Tomohiro, Kume Noriaki, Okumura Ken
Department of Cardiology, Hirosaki University Graduate School of Medicine.
Circ J. 2015;79(3):641-8. doi: 10.1253/circj.CJ-14-0904. Epub 2015 Jan 23.
Soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) level is a reliable prognostic biomarker in acute coronary syndrome. However, it is unclear whether its plasma level at acute phase is related to the long-term prognosis in patients with ST-segment elevation acute myocardial infarction (STEMI). METHODS AND RESULTS: We prospectively examined the relation between plasma sLOX-1 level on admission and prognosis in 153 consecutive STEMI patients admitted within 24 h of onset. Primary percutaneous coronary intervention was performed in 144 patients. The patients were divided into 2 groups by the median value (71 pg/ml) of plasma sLOX-1 level on admission [sLOX-1 level ≤71 pg/ml (n=77) and >71 pg/ml (n=76)], and were followed for median of 1,156 days. All-cause mortality and the combined endpoints of major adverse cardiovascular events (MACE) defined as cardiovascular mortality and recurrent MI were both significantly higher in patients with sLOX-1 values above median than in those below median (25.0% vs. 3.9%, P<0.001, and 19.4% vs. 6.5%, P=0.019 by log-rank test, respectively). Even after adjustment for confounders, a level of sLOX-1 above median was an independent predictor for all-cause mortality (hazard ratio (HR): 5.893; 95% confidence interval (CI): 1.665-20.854, P=0.006) and MACE (HR: 3.457; 95% CI: 1.164-10.270, P=0.030).
Elevated plasma sLOX-1 level on admission independently predicts long-term all-cause mortality and MACE after STEMI.
可溶性凝集素样氧化型低密度脂蛋白受体-1（sLOX-1）水平是急性冠状动脉综合征中一种可靠的预后生物标志物。然而，急性期其血浆水平是否与ST段抬高型急性心肌梗死（STEMI）患者的长期预后相关尚不清楚。
我们前瞻性地研究了153例发病24小时内入院的连续STEMI患者入院时血浆sLOX-1水平与预后的关系。144例患者接受了直接经皮冠状动脉介入治疗。根据入院时血浆sLOX-1水平的中位数（71 pg/ml）将患者分为两组[sLOX-1水平≤71 pg/ml（n=77）和>71 pg/ml（n=76）]，并随访1156天。sLOX-1值高于中位数的患者全因死亡率和定义为心血管死亡和复发性心肌梗死的主要不良心血管事件（MACE）联合终点均显著高于低于中位数的患者（分别为25.0%对3.9%，P<0.001，以及19.4%对6.5%，对数秩检验P=0.019）。即使在对混杂因素进行调整后，sLOX-1水平高于中位数仍是全因死亡率（风险比（HR）：5.893；95%置信区间（CI）：1.665-20.854，P=0.006）和MACE（HR：3.457；95%CI：1.164-10.270，P=0.030）的独立预测因素。
入院时血浆sLOX-1水平升高独立预测STEMI后的长期全因死亡率和MACE。
