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半乳糖凝集素-3对冠心病发生、心肌梗死后预后的预测价值及其与这些患者颈动脉内膜中层厚度值的关联:一项中期前瞻性队列研究。

Predictive value of Galectin-3 for the occurrence of coronary artery disease and prognosis after myocardial infarction and its association with carotid IMT values in these patients: A mid-term prospective cohort study.

作者信息

Lisowska Anna, Knapp Małgorzata, Tycińska Agnieszka, Motybel Elżbieta, Kamiński Karol, Święcki Przemysław, Musiał Włodzimierz J, Dymicka-Piekarska Violetta

机构信息

Department of Cardiology, Medical University, Ul. Sklodowskiej 24A, 15-276 Bialystok, Poland.

Department of Cardiology, Medical University, Ul. Sklodowskiej 24A, 15-276 Bialystok, Poland.

出版信息

Atherosclerosis. 2016 Mar;246:309-17. doi: 10.1016/j.atherosclerosis.2016.01.022. Epub 2016 Jan 14.

Abstract

OBJECTIVE

The role of Galectin-3(Gal-3) in atherosclerosis progression has not been definitely acknowledged. The aim of the study was to establish the following: whether Gal-3 may act as an independent risk factor of coronary artery disease (CAD) occurrence and its advancement, if Gal-3 has potential relations with classical and new markers of cardiovascular risk (carotid intima-media thickness (cIMT), and whether Gal-3 may be a marker of mortality in the group of patients with myocardial infarction (MI) during mid-term follow-up.

PATIENTS AND METHODS

The study group was composed of 233 patients with MI and 100 patients with a stable CAD. Selected risk factors were assessed, Gal-3 concentrations and cIMT were measured. The control group was composed of 100 healthy individuals.

RESULTS

In the study group (MI and CAD patients) Gal-3 concentration was significantly higher than in the controls--median 7.9 ng/ml (p = 0.0001) and 10.7 ng/ml (p = 0.00001) vs. 5.5 ng/ml, respectively. Patients with 3-vessel disease had higher levels of Gal-3 than patients with 1-or 2-vessel disease (9.2 ng/ml vs 7.4 ng/ml, p = 0.003). In the group of MI patients who died during the follow-up (average period - 2.8 years), we found a significantly higher concentration of Gal-3 (20.0 ng/ml vs 8.0 ng/ml, p = 0.0005) and cIMT values (common carotid artery(CCA): 1.4 ± 0.4 mm vs. 1.0 ± 0.3 mm, p = 0.03; carotid bulb(CB): 2.3 ± 0.5 mm vs. 1.9 ± 0.4 mm, p = 0.009). In the model of multivariate logistic regression analysis, the variables influencing the mortality after MI during follow-up were: age>65 years, Gal-3 concentration>8.7 ng/ml, IMT values and plaque occurrence in CB, previous MI and EF<40%.

CONCLUSIONS

Gal-3 is an independent risk factor of CAD occurrence, but cIMT values are better markers of CAD advancement. Both Gal-3 concentration>8.7 ng/ml and IMT values in CB were an independent predictive indicators of increased risk of all-cause mortality in patients after MI during mid-term follow up.

摘要

目的

半乳糖凝集素-3(Gal-3)在动脉粥样硬化进展中的作用尚未得到明确认可。本研究的目的是确定以下内容:Gal-3是否可能作为冠状动脉疾病(CAD)发生及其进展的独立危险因素,Gal-3与心血管风险的经典和新标志物(颈动脉内膜中层厚度(cIMT))是否存在潜在关系,以及Gal-3是否可能是心肌梗死(MI)患者中期随访期间死亡的标志物。

患者与方法

研究组由233例MI患者和100例稳定型CAD患者组成。评估了选定的危险因素,测量了Gal-3浓度和cIMT。对照组由100名健康个体组成。

结果

在研究组(MI和CAD患者)中,Gal-3浓度显著高于对照组——中位数分别为7.9 ng/ml(p = 0.0001)和10.7 ng/ml(p = 0.00001),而对照组为5.5 ng/ml。三支血管病变患者的Gal-3水平高于单支或双支血管病变患者(9.2 ng/ml对7.4 ng/ml,p = 0.003)。在随访期间死亡的MI患者组(平均随访期 - 2.8年)中,我们发现Gal-3浓度显著更高(20.0 ng/ml对8.0 ng/ml,p = 0.0005)以及cIMT值更高(颈总动脉(CCA):1.4±0.4 mm对1.0±0.3 mm,p = 0.03;颈动脉窦(CB):2.3±0.5 mm对1.9±0.4 mm,p = 0.009)。在多因素逻辑回归分析模型中,影响MI患者随访期间死亡率的变量为:年龄>65岁、Gal-3浓度>8.7 ng/ml、IMT值和CB处斑块的出现、既往MI以及射血分数<40%。

结论

Gal-3是CAD发生的独立危险因素,但cIMT值是CAD进展的更好标志物。Gal-3浓度>8.7 ng/ml和CB处的IMT值均是MI患者中期随访期间全因死亡风险增加的独立预测指标。

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