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急性ST段抬高型心肌梗死后白细胞端粒长度与左心室功能:来自糖代谢干预作为ST段抬高型心肌梗死直接冠状动脉介入治疗辅助手段(GIPS-III)试验的数据

Leukocyte telomere length and left ventricular function after acute ST-elevation myocardial infarction: data from the glycometabolic intervention as adjunct to primary coronary intervention in ST elevation myocardial infarction (GIPS-III) trial.

作者信息

Haver Vincent G, Hartman Minke H T, Mateo Leach Irene, Lipsic Erik, Lexis Chris P, van Veldhuisen Dirk J, van Gilst Wiek H, van der Horst Iwan C, van der Harst Pim

机构信息

Department of Cardiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands.

Department of Intensive Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

出版信息

Clin Res Cardiol. 2015 Oct;104(10):812-21. doi: 10.1007/s00392-015-0848-x. Epub 2015 Apr 4.

Abstract

BACKGROUND

Telomere length has been associated with coronary artery disease and heart failure. We studied whether leukocyte telomere length is associated with left ventricular ejection fraction (LVEF) after ST-elevation myocardial infarction (STEMI).

METHODS AND RESULTS

Leukocyte telomere length (LTL) was determined using the monochrome multiplex quantitative PCR method in 353 patients participating in the glycometabolic intervention as adjunct to primary percutaneous coronary intervention in STEMI III trial. LVEF was assessed by magnetic resonance imaging. The mean age of patients was 58.9 ± 11.6 years, 75 % were male. In age- and gender-adjusted models, LTL at baseline was significantly associated with age (beta ± standard error; -0.33 ± 0.01; P < 0.01), gender (0.15 ± 0.03; P < 0.01), TIMI flow pre-PCI (0.05 ± 0.03; P < 0.01), TIMI flow post-PCI (0.03 ± 0.04; P < 0.01), myocardial blush grade (-0.05 ± 0.07; P < 0.01), serum glucose levels (-0.11 ± 0.01; P = 0.03), and total leukocyte count (-0.11 ± 0.01; P = 0.04). At 4 months after STEMI, LVEF was well preserved (54.1 ± 8.4 %) and was not associated with baseline LTL (P = 0.95). Baseline LTL was associated with n-terminal pro-brain natriuretic peptide (NT-proBNP) at 4 months (-0.14 ± 0.01; P = 0.02), albeit not independent for age and gender.

CONCLUSION

Our study does not support a role for LTL as a causal factor related to left ventricular ejection fraction after STEMI.

摘要

背景

端粒长度与冠状动脉疾病和心力衰竭有关。我们研究了白细胞端粒长度是否与ST段抬高型心肌梗死(STEMI)后的左心室射血分数(LVEF)相关。

方法与结果

在STEMI III试验中,采用单色多重定量PCR方法测定了353例参与糖代谢干预作为直接经皮冠状动脉介入治疗辅助措施的患者的白细胞端粒长度(LTL)。通过磁共振成像评估LVEF。患者的平均年龄为58.9±11.6岁,75%为男性。在年龄和性别校正模型中,基线时的LTL与年龄(β±标准误;-0.33±0.01;P<0.01)、性别(0.15±0.03;P<0.01)、PCI术前TIMI血流(0.05±0.03;P<0.01)、PCI术后TIMI血流(0.03±0.04;P<0.01)、心肌造影分级(-0.05±0.07;P<0.01)、血糖水平(-0.11±0.01;P=0.03)和白细胞总数(-0.11±0.01;P=0.04)显著相关。STEMI后4个月时,LVEF保存良好(54.1±8.4%),且与基线LTL无关(P=0.95)。基线LTL与4个月时的N末端脑钠肽前体(NT-proBNP)相关(-0.14±0.01;P=0.02),尽管在年龄和性别方面并非独立相关。

结论

我们的研究不支持LTL作为STEMI后与左心室射血分数相关的因果因素发挥作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4ba/4580719/401626a5dff2/392_2015_848_Fig1_HTML.jpg

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