Rath Dominik, Chatterjee Madhumita, Bongartz Angela, Müller Karin, Droppa Michal, Stimpfle Fabian, Borst Oliver, Zuern Christine, Vogel Sebastian, Gawaz Meinrad, Geisler Tobias
a Medizinische Klinik III, Kardiologie und Kreislauferkrankungen , University Tübingen , Tübingen , Germany.
Platelets. 2017 Jan;28(1):34-39. doi: 10.1080/09537104.2016.1203399. Epub 2016 Jul 27.
Platelet surface expression levels of stromal cell derived factor 1 (SDF-1) are elevated in acute coronary syndrome and associated with LVEF% improvement after myocardial infarction (MI). Platelet SDF-1 might facilitate thrombus formation and endomyocardial expression of SDF-1 is enhanced in inflammatory cardiomyopathy and positively correlates with myocardial fibrosis. The influence of platelet SDF-1 on outcome in the patients with symptomatic coronary artery disease (CAD) is to the best of our knowledge unknown. Blood samples of 608 consecutive CAD patients were collected during the percutaneous coronary intervention and analyzed for surface expression of SDF-1 by flow cytometry. The primary combined endpoint was defined as the composite of either MI, or ischemic stroke, or all-cause death. Secondary endpoints were defined as the aforementioned single events. The patients with baseline platelet SDF-1 levels above the third quartile showed a significantly worse cumulative event-free survival when compared to the patients with lower baseline SDF-1 levels (first to third quartile) (log rank 0.009 for primary combined endpoint and log rank 0.016 for secondary endpoint all-cause death). Multivariate Cox regression analysis showed that SDF-1 levels above the third quartile were independently associated with the primary combined endpoint and the secondary endpoint all-cause death. We provide first clinical evidence that high platelet expression levels of SDF-1 influence clinical outcomes in CAD patients in a negative way.
急性冠状动脉综合征患者血小板表面基质细胞衍生因子1（SDF-1）表达水平升高，且与心肌梗死后左心室射血分数（LVEF%）的改善相关。血小板SDF-1可能促进血栓形成，炎症性心肌病患者心内膜SDF-1表达增强，且与心肌纤维化呈正相关。据我们所知，血小板SDF-1对有症状冠状动脉疾病（CAD）患者预后的影响尚不清楚。在经皮冠状动脉介入治疗期间收集了608例连续CAD患者的血样，并通过流式细胞术分析SDF-1的表面表达。主要联合终点定义为心肌梗死、缺血性中风或全因死亡的复合终点。次要终点定义为上述单一事件。与基线SDF-1水平较低（第一至第三四分位数）的患者相比，基线血小板SDF-1水平高于第三四分位数的患者累积无事件生存率显著更差（主要联合终点的对数秩为0.009，次要终点全因死亡的对数秩为0.016）。多变量Cox回归分析显示，高于第三四分位数的SDF-1水平与主要联合终点和次要终点全因死亡独立相关。我们提供了首个临床证据，即血小板SDF-1高表达水平对CAD患者的临床结局有负面影响。
