Zhang Baowei, Peng Wenhui, Wang Ke, Li Hailing, Xu Yawei
Heart Lung Circ. 2016 Mar;25(3):257-64. doi: 10.1016/j.hlc.2015.07.001.
Our previous study showed that patients with acute myocardial infarction (AMI) had lower levels of vaspin than patients without AMI. The aim of this study was to investigate the clinical significance of vaspin in patients with AMI.
A total of 80 patients with AMI were enrolled. Plasma vaspin levels, clinical parameters, lipid profile, C reactive protein (CRP) were measured. All the patients were followed-up for 24±2 months for the occurrence of major adverse major cardiac events (MACEs).
During the follow-up, 48 patients experienced a MACE. The plasma vaspin concentrations in the MACEs-positive group were lower than those in the MACEs-negative group (0.156 ± 0.015 vs 0.314 ± 0.229ng/mL, p<0.001). Receiver operating characteristic curves showed that circulating vaspin concentration significantly differentiated patients with MACEs (p<0.001). The optimal cutoff value for predicting MACE was 0.259ng/mL. Then the patients were divided into vaspin>0.259ng/mL group and vaspin<0.259ng/mL group according to the plasma vaspin levels. Forty-five patients (74%) in the vaspin<0.259ng/mL group and three (16%) patients in the vaspin>0.259ng/mL group experienced a MACE. Multivariate survival analyses showed that the vaspin level (hazard ratio, HR 0.423) independently predicted the occurrence of MACEs. Compared with the results of echocardiography at admission, the improvement of LVEF in the vaspin>0.259ng/mL group was significant (54.3±7.6% to 61.2±4.7%, p<0.001), but the change of LVEF in the low vaspin group was not significant (51.3±9.7% to 52.5±10.9%).
Vaspin might be a useful predictive biomarker in patients with AMI, and patients with low vaspin levels might have a high risk of a MACE. In addition, vaspin might have protective effects on the improvement of LVEF after AMI.
我们之前的研究表明，急性心肌梗死（AMI）患者的内脏脂肪素水平低于非AMI患者。本研究旨在探讨内脏脂肪素在AMI患者中的临床意义。
共纳入80例AMI患者。检测血浆内脏脂肪素水平、临床参数、血脂谱、C反应蛋白（CRP）。所有患者随访24±2个月，观察主要不良心脏事件（MACE）的发生情况。
随访期间，48例患者发生MACE。MACE阳性组的血浆内脏脂肪素浓度低于MACE阴性组（0.156±0.015 vs 0.314±0.229ng/mL，p<0.001）。受试者工作特征曲线显示，循环内脏脂肪素浓度可显著区分发生MACE的患者（p<0.001）。预测MACE的最佳截断值为0.259ng/mL。然后根据血浆内脏脂肪素水平将患者分为内脏脂肪素>0.259ng/mL组和内脏脂肪素<0.259ng/mL组。内脏脂肪素<0.259ng/mL组中有45例（74%）患者发生MACE，内脏脂肪素>0.259ng/mL组中有3例（16%）患者发生MACE。多因素生存分析显示，内脏脂肪素水平（风险比，HR 0.423）可独立预测MACE的发生。与入院时的超声心动图结果相比，内脏脂肪素>0.259ng/mL组的左心室射血分数（LVEF）改善显著（54.3±7.6%至61.2±4.7%，p<0.001），但低内脏脂肪素组的LVEF变化不显著（51.3±9.7%至52.5±10.9%）。
内脏脂肪素可能是AMI患者有用的预测生物标志物，内脏脂肪素水平低的患者发生MACE的风险可能较高。此外，内脏脂肪素可能对AMI后LVEF的改善具有保护作用。
