Li Jing-Wei, Chen Yun-Dai, Chen Wei-Ren, You Qi, Li Bo, Zhou Hao, Zhang Ying, Han Tian-Wen
Department of Cardiology, People's Liberation Army General Hospital, No. 28 Fuxing Road, Wukesong, Haidian District, Beijing, 100853, China.
Department of Cardiology, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Cardiovasc Diabetol. 2017 Jun 6;16(1):72. doi: 10.1186/s12933-017-0553-3.
Dipeptidyl peptidase-4 (DPP4) regulates blood glucose levels and inflammation, and it is also implicated in the pathophysiological process of myocardial infarction (MI). Plasma DPP4 activity (DPP4a) may provide prognostic information regarding outcomes for ST-segment elevation MI (STEMI) patients.
Blood samples were obtained from 625 consecutively admitted, percutaneous coronary intervention-treated STEMI patients with a mean age of 57 years old. DPP4a was quantified using enzymatic assays.
The median follow-up period was 30 months. Multivariate Cox-regression analyses (adjusted for confounding variables) showed that a 1 U/L increase of DPP4a did not associate with risks of major adverse cardiac or cerebrovascular events (MACCE), cardiovascular mortality, MI, heart failure readmission, stroke, non-cardiovascular mortality and repeated revascularization. However, in a subset of 149 diabetic STEMI patients, DPP4a associated with an increased risk of MACCE (HR 1.16; 95% CI 1.04-1.30; p = 0.01).
DPP4a did not associate with cardiovascular events and non-cardiovascular mortality in non-diabetic STEMI patients. However, DPP4a may be associated with future MACCE in diabetic STEMI patients. Trial registration NCT03046576, registered on 5 February, 2017, retrospectively registered.
二肽基肽酶-4（DPP4）调节血糖水平和炎症反应，并且还参与心肌梗死（MI）的病理生理过程。血浆DPP4活性（DPP4a）可能为ST段抬高型心肌梗死（STEMI）患者的预后提供信息。
从625例连续入院且接受经皮冠状动脉介入治疗的STEMI患者中采集血样，这些患者的平均年龄为57岁。采用酶法对DPP4a进行定量分析。
中位随访期为30个月。多因素Cox回归分析（对混杂变量进行校正）显示，DPP4a每升高1 U/L与主要不良心脑血管事件（MACCE）、心血管死亡率、心肌梗死、心力衰竭再入院、中风、非心血管死亡率及重复血运重建的风险无关。然而，在149例糖尿病STEMI患者亚组中，DPP4a与MACCE风险增加相关（HR 1.16；95%CI 1.04-1.30；P = 0.01）。
在非糖尿病STEMI患者中，DPP4a与心血管事件及非心血管死亡率无关。然而，DPP4a可能与糖尿病STEMI患者未来发生MACCE相关。试验注册编号NCT03046576，于2017年2月5日注册登记，为回顾性注册。
