Leu Hsin-Bang, Yin Wei-Hsian, Tseng Wei-Kung, Wu Yen-Wen, Lin Tsung-Hsien, Yeh Hung-I, Chang Kuan-Cheng, Wang Ji-Hung, Wu Chau-Chung, Chen Jaw-Wen
Institute of Clinical Medicine and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.
Heath Care and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan.
BMC Cardiovasc Disord. 2017 Jan 28;17(1):42. doi: 10.1186/s12872-017-0471-z.
Either classic or novel biomarkers have not been well investigated for clinical outcomes of coronary artery disease (CAD) in Asian people especially ethnic Chinese. We reported here a prospective national-based follow-up study that aims to elucidate the clinical profiles and to identify the new biosignatures (especially the non-lipid profile and inflammatory biomakers) for future clinical outcomes in a sizable cohort of stable CAD patients in Taiwan.
A total of 2500 CAD patients under stable condition after successful percutaneous coronary intervention will be enrolled for clinical data collection and blood/urine sampling in northern, southern, western, or eastern part of Taiwan between 2012 and 2017. They will be regularly followed up at least annually for 5 years to assess all cause deaths, hard clinical events (including cardiovascular death, nonfatal myocardial infarction, nonfatal stroke), and total cardiovascular events (including hard events, unplanned revascularization procedures, unplanned hospitalization for refractory or unstable angina, and for other causes such as stroke, transient ischemic attack, heart failure, or peripheral arterial occlusive disease). The classic and newly defined biosignatures will be compared in patients with and without clinical events during follow-up. The novel biomarkers will be identified via metabolomics analyses. Additionally, psychological personality and lifestyle data will be incorporated to explore the new dimensional views of the complex mechanisms of the disease. Till December 2014, the initial 1663 patients have been successfully enrolled. Among them, 85.93% are male; 36.22% have type 2 diabetes; 64.82% have hypertension; 56.04% are smokers and 20.44% have a family history of CAD. Their lipid profiles are under contemporary medical control with a mean plasma total cholesterol level of 163.51 ± 36.99 mg/dL and a mean low-density lipoprotein cholesterol level of 95.21 ± 29.98 mg/dL.
This nationwide study has successfully started to update the contemporary information and to investigate the potential predictors for clinical outcomes of stable CAD patients in Taiwan. The identification of new biomarkers, lifestyle and psychological personality may help to elucidate the complex mechanisms and provide the novel rational to the individual treatment strategies in Asian especially ethnic Chinese patients with CAD.
无论是经典生物标志物还是新型生物标志物，对于亚洲人群尤其是华裔人群冠状动脉疾病（CAD）的临床结局尚未得到充分研究。我们在此报告一项基于全国的前瞻性随访研究，旨在阐明临床特征，并在台湾相当数量的稳定CAD患者队列中识别用于预测未来临床结局的新生物标志物（尤其是非脂质谱和炎症生物标志物）。
2012年至2017年期间，台湾北部、南部、西部或东部将招募总共2500名经皮冠状动脉介入治疗成功后病情稳定的CAD患者，进行临床数据收集和血液/尿液样本采集。他们将至少每年定期随访5年，以评估全因死亡、严重临床事件（包括心血管死亡、非致命性心肌梗死、非致命性中风）以及总心血管事件（包括严重事件、计划外血管重建手术、因难治性或不稳定型心绞痛以及其他原因如中风、短暂性脑缺血发作、心力衰竭或外周动脉闭塞性疾病而计划外住院）。将对随访期间发生和未发生临床事件的患者的经典和新定义生物标志物进行比较。新型生物标志物将通过代谢组学分析来识别。此外，将纳入心理性格和生活方式数据，以探索该疾病复杂机制的新维度观点。截至2014年12月，已成功招募了最初的1663名患者。其中，85.93%为男性；36.22%患有2型糖尿病；64.82%患有高血压；56.04%为吸烟者，20.44%有CAD家族史。他们的血脂谱处于当代医学控制之下，血浆总胆固醇平均水平为163.5 ± 36.99mg/dL，低密度脂蛋白胆固醇平均水平为95.21 ± 29.98mg/dL。
这项全国性研究已成功开始更新当代信息，并调查台湾稳定CAD患者临床结局的潜在预测因素。新生物标志物、生活方式和心理性格的识别可能有助于阐明复杂机制，并为亚洲尤其是华裔CAD患者的个体化治疗策略提供新的理论依据。
