C反应蛋白作为慢性稳定型冠心病患者侧支循环不良的预测指标。
C-reactive protein as a predictor for poor collateral circulation in patients with chronic stable coronary heart disease.
作者信息
Fan Ying, Li Sha, Li Xiao-Lin, Zhu Cheng-Gang, Guo Yuan-Lin, Wu Na-Qiong, Qing Ping, Gao Ying, Dong Qian, Liu Geng, Li Jian-Jun
机构信息
a Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital , National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China ;
b Department of Cardiology , the Fifth Hospital of Wuhan & Affiliated Guangci Hospital of Wuhan University , Wuhan , China.
出版信息
Ann Med. 2016;48(1-2):83-8. doi: 10.3109/07853890.2015.1136429. Epub 2016 Jan 20.
AIM
To investigate the association between serum C-reactive protein (CRP) levels and coronary collateral circulation (CCC) in Chinese patients with angiography-proven ≥95% coronary stenosis.
METHODS
In this study, 1158 patients with angiography-proven ≥95% occlusion in ≥1 major epicardial coronary artery were enrolled, and then classified into two groups: poor CCC (Rentrop grades 0-1) and good CCC (Rentrop grades 2-3). CRP levels were grouped using the following two models: Model 1 discretized CRP group with 33.33% and 66.66% as the critical values and Model 2 with 1.0 and 3.0 mg/L as the cut off values.
RESULTS
There were significant differences in serum CRP levels between the two groups (5.76 ± 3.45 vs. 3.49 ± 2.44 mg/L, respectively; p < 0.001), and compared with the first CRP tertile, the risks of poor CCC were higher in the second and third CRP tertiles (OR 2.31, 95%CI [1.67-3.19], OR 6.25, 95%CI [4.52-8.62], respectively). The receiver operating characteristic curve analysis indicated that the optimal cutoff value of CRP to predict poor CCC was 4.21 mg/L with 59.6% sensitivity and 74.33% specificity.
CONCLUSIONS
CRP levels are an independent predictor for poor CCC and might supply a useful biomarker in clinical applications. Key messages C-reactive protein (CRP) is a non-specific inflammatory marker that is regarded as an independent risk and prognostic factor for individuals who suffer from coronary artery disease (CAD) and cardiovascular disorders. In a Chinese cohort of patients with coronary artery occlusion or stenosis of ≥95% TIMI grade 1 anterograde-flow, the relationship between CRP concentrations and angiographically visible coronary collateral (CC) was assessed. Our data indicated that elevated CRP associated with a significant impairment in CC development, and might supply a useful biomarker in clinical applications.
目的
探讨经血管造影证实冠状动脉狭窄≥95%的中国患者血清C反应蛋白(CRP)水平与冠状动脉侧支循环(CCC)之间的关联。
方法
本研究纳入1158例经血管造影证实至少1支主要心外膜冠状动脉闭塞≥95%的患者,然后分为两组:CCC不良组(Rentrop分级0 - 1级)和CCC良好组(Rentrop分级2 - 3级)。CRP水平采用以下两种模型分组:模型1以33.33%和66.66%作为临界值对CRP进行离散分组,模型2以1.0和3.0 mg/L作为截断值。
结果
两组血清CRP水平存在显著差异(分别为5.76±3.45 vs. 3.49±2.44 mg/L;p < 0.001),与CRP三分位数的第一组相比,第二和第三CRP三分位数组中CCC不良的风险更高(分别为OR 2.31,95%CI [1.67 - 3.19],OR 6.25,95%CI [4.52 - 8.62])。受试者工作特征曲线分析表明,预测CCC不良的CRP最佳截断值为4.21 mg/L,灵敏度为59.6%,特异度为74.33%。
结论
CRP水平是CCC不良的独立预测因子,可能为临床应用提供一种有用的生物标志物。关键信息C反应蛋白(CRP)是一种非特异性炎症标志物,被视为患有冠状动脉疾病(CAD)和心血管疾病个体的独立风险和预后因素。在一个经血管造影证实冠状动脉闭塞或狭窄≥95%且TIMI血流1级顺行的中国患者队列中,评估了CRP浓度与血管造影可见的冠状动脉侧支(CC)之间的关系。我们的数据表明,CRP升高与CC发育的显著受损相关,并且可能为临床应用提供一种有用的生物标志物。