George Melvin, Shanmugam Elangovan, Srivatsan Varsha, Vasanth Karunamoorthy, Ramraj Balaji, Rajaram Muthukumar, Jena Amrita, Sridhar Aruna, Chaudhury Minakshi, Kaliappan Ilango
Department of Cardiology, SRM Medical College Hospital & Research Centre, Kattankulathur, Kancheepuram, Chennai, Tamil Nadu 603203, India
Department of Cardiology, SRM Medical College Hospital & Research Centre, Chennai, India.
Ther Adv Cardiovasc Dis. 2015 Oct;9(5):275-84. doi: 10.1177/1753944715578405. Epub 2015 Mar 25.
Acute coronary syndrome (ACS) continues to be a leading cause of morbidity and mortality worldwide. Galectin-3 and pentraxin-3 are two prognostic biomarkers that have been studied in heart failure (HF). However, there are limited data on these biomarkers in the ACS population. The objective of the study was to determine the variables that are most affected by high concentrations of pentraxin-3 and galectin-3, and the influence they have on outcomes of all-cause mortality in patients with ACS.
We included a total of 160 patients [ST elevation myocardial infarction (STEMI),n = 64; non STEMI/unstable angina (NSTEMI/UA), n = 38; and control subjects with chronic stable angina (CSA)/microvascular angina (MVA) n = 58]. Plasma pentraxin-3 and galectin-3 levels were assessed from these patients at the time of hospital admission. Major adverse cardiovascular events including all-cause mortality, rehospitalizations and coronary artery bypass graft surgery (CABG) were assessed at 6 months.
The median concentration of pentraxin-3 and galectin-3 were significantly higher in STEMI than in NSTEMI patients (p < 0.005) or controls (p < 0.005). Greater numbers of deaths (4 versus 0) were observed in STEMI patients with higher levels of these biomarkers. In addition, ACS patients with high levels of pentraxin-3 and galectin-3 had lower left ventricular ejection fraction (LVEF) (p < 0.005), and a moderate correlation was observed between LVEF and pentraxin-3 levels (r = -0.45, p < 0.005). Patients with higher galectin-3 levels were also observed to have a lower estimated glomerular fraction rate (eGFR), and a moderate correlation was observed between them (r = -0.34, p < 0.005).
Pentraxin-3 and galectin-3 hold much promise in the ACS population as prognostic biomarkers.
急性冠状动脉综合征（ACS）仍是全球发病和死亡的主要原因。半乳糖凝集素-3和五聚体蛋白-3是已在心力衰竭（HF）中进行研究的两种预后生物标志物。然而，关于ACS人群中这些生物标志物的数据有限。本研究的目的是确定受高浓度五聚体蛋白-3和半乳糖凝集素-3影响最大的变量，以及它们对ACS患者全因死亡率结局的影响。
我们共纳入了160例患者[ST段抬高型心肌梗死（STEMI），n = 64；非STEMI/不稳定型心绞痛（NSTEMI/UA），n = 38；以及慢性稳定型心绞痛（CSA）/微血管性心绞痛（MVA）对照受试者，n = 58]。在这些患者入院时评估血浆五聚体蛋白-3和半乳糖凝集素-3水平。在6个月时评估主要不良心血管事件，包括全因死亡率、再住院率和冠状动脉旁路移植术（CABG）。
STEMI患者中五聚体蛋白-3和半乳糖凝集素-3的中位浓度显著高于NSTEMI患者（p < 0.005）或对照受试者（p < 0.005）。在这些生物标志物水平较高的STEMI患者中观察到更多的死亡病例（4例对0例）。此外，五聚体蛋白-3和半乳糖凝集素-3水平高的ACS患者左心室射血分数（LVEF）较低（p < 0.005），并且在LVEF与五聚体蛋白-3水平之间观察到中度相关性（r = -0.45，p < 0.005）。还观察到半乳糖凝集素-3水平较高的患者估计肾小球滤过率（eGFR）较低，并且在它们之间观察到中度相关性（r = -0.34，p < 0.005）。
五聚体蛋白-3和半乳糖凝集素-3作为预后生物标志物在ACS人群中很有前景。
