Li Xiaohui, Wu Xing, Li Hongwei, Chen Hui, Wang Yongliang, Li Weiping, Ding Xiaosong, Hong Xu
Capital Medical University.
Cardiol J. 2016;23(4):456-64. doi: 10.5603/CJ.a2016.0031. Epub 2016 Jun 20.
Few clinical studies have assessed Rho kinase (ROCK) in patients with dia-betes mellitus (DM) and ST-segment elevation myocardial infarction (STEMI). This study aimed to determine whether ROCK activity in circulating leukocytes is increased in STEMI patients with DM and whether ROCK activity predicts the onset of cardiovascular events.
Blood samples were collected from 60 STEMI patients, divided into non-diabetes mellitus (NDM) and DM groups. Main outcome measures were all-cause mortality, readmission for acute coronary syndrome (ACS), congestive heart failure (CHF), or stroke from pres-entation to approximately 5 years (mean: 41.3 ± 19.6 months; range: 3-60 months).
Compared with the NDM group (n = 34), ROCK1 activity was greater in the DM group (n = 26) (33.14 ± 11.31 vs. 26.24 ± 11.06, p = 0.021), while ROCK2 activity was not different between the groups. There occurred 3 deaths, and 10 readmissions with ACS, 4 with CHF and 2 with stroke during the follow-up period. Patients with a high ROCK1 activity on admission had a 3-fold risk of cardiovascular events (RR 3.15, 95% CI 1.04-9.58) compared with those with low ROCK1 activity. Patients with history of stroke had almost a 4-fold risk of cardiovascular events (RR 3.74; 95% CI 1.02-13.80).
ROCK1 activity was increased in STEMI patients with DM, which suggests that ROCK1 activity may be a useful diagnostic and prognostic marker of cardiovascular events for these patients. ROCK1 activity might help identify a subset of STEMI patients at particularly high risk.
很少有临床研究评估糖尿病(DM)合并ST段抬高型心肌梗死(STEMI)患者的 Rho 激酶(ROCK)。本研究旨在确定 DM 合并 STEMI 患者循环白细胞中的 ROCK 活性是否升高,以及 ROCK 活性是否可预测心血管事件的发生。
从60例 STEMI 患者中采集血样,分为非糖尿病(NDM)组和 DM 组。主要观察指标为全因死亡率、急性冠状动脉综合征(ACS)、充血性心力衰竭(CHF)或卒中再入院率,观察时间从就诊至约5年(平均:41.3±19.6个月;范围:3 - 60个月)。
与 NDM 组(n = 34)相比,DM 组(n = 26)的 ROCK1 活性更高(33.14±11.31对26.24±11.06,p = 0.021),而两组间 ROCK2 活性无差异。随访期间发生3例死亡,10例因 ACS 再入院,4例因 CHF 再入院,2例因卒中再入院。入院时 ROCK1 活性高的患者发生心血管事件的风险是 ROCK1 活性低的患者的3倍(风险比3.15,95%置信区间1.04 - 9.58)。有卒中病史的患者发生心血管事件的风险几乎是4倍(风险比3.74;95%置信区间1.02 - 13.80)。
DM 合并 STEMI 患者的 ROCK1 活性升高,这表明 ROCK1 活性可能是这些患者心血管事件的有用诊断和预后标志物。ROCK1 活性可能有助于识别出特别高危的 STEMI 患者亚组。