Şen Ömer, Topuz Mustafa, Acele Armağan, Akkuş Oğuz, Baykan Ahmet Oytun, Koç Mevlüt
Adana Numune Training anda Research Hospital.
Cardiol J. 2017;24(6):677-684. doi: 10.5603/CJ.a2017.0066. Epub 2017 Jun 14.
The preventive role of acute occurring of collateral circulation (AOCC) to infarct related artery (IRA) in patients presenting with acute ST-segment elevation myocardial infarction (STEMI) is well known. Therefore, we aimed to investigate whether there is an association between admission plasma 25-hydroxyvitamin D (25(OH)D3) levels and grade of collateralization in patients with STEMI.
We prospectively included 369 STEMI patients within the first 12 h of symptoms onset. Patients were divided into two groups according to their Rentrop collateralization grade to IRA: poorly developed collateral (PDC) group (Rentrop grade ≤ 1, 272 patients) and well developed collateral (WDC) group (Rentrop grade ≥ 2, 97 patients).
We observed that AOCC grade to IRA was negatively correlated with high sensitive C-reactive protein (hs-CRP), N terminal pro-B-type natriuretic peptide (NT-proBNP), as well as peak troponin T levels, yet positively correlated with admission plasma 25(OH)D3 level (p < 0.05, for all). In multi¬variate analysis, 25(OH)D3 levels (OR 1.246, 95% CI 1.185-1.310, p < 0.001), together with hs-CRP, NT-proBNP, and peak troponin T levels were found independent predictors of AOCC to IRA in patients with acute STEMI.
Admission level of plasma 25(OH)D3 levels together with cardiac risk biomarkers (troponin T, NT-proBNP, hs-CRP) are associated with collateralization grade to IRA in acute STEMI patients. In addition, 25(OH)D3 may be a promoter of AOCC in patients with acute STEMI.
急性ST段抬高型心肌梗死（STEMI）患者中，梗死相关动脉（IRA）侧支循环急性形成（AOCC）的预防作用已广为人知。因此，我们旨在研究STEMI患者入院时血浆25-羟维生素D（25(OH)D3）水平与侧支循环分级之间是否存在关联。
我们前瞻性纳入了症状发作后12小时内的369例STEMI患者。根据IRA的Rentrop侧支循环分级将患者分为两组：侧支循环发育不良（PDC）组（Rentrop分级≤1，272例患者）和侧支循环发育良好（WDC）组（Rentrop分级≥2，97例患者）。
我们观察到，IRA的AOCC分级与高敏C反应蛋白（hs-CRP）、N末端B型利钠肽原（NT-proBNP）以及肌钙蛋白T峰值水平呈负相关，但与入院时血浆25(OH)D3水平呈正相关（所有p<0.05）。在多变量分析中，发现25(OH)D3水平（OR 1.246，95%CI 1.185-1.310，p<0.001）以及hs-CRP、NT-proBNP和肌钙蛋白T峰值水平是急性STEMI患者IRA的AOCC的独立预测因素。
急性STEMI患者入院时血浆25(OH)D3水平与心脏风险生物标志物（肌钙蛋白T、NT-proBNP、hs-CRP）与IRA的侧支循环分级相关。此外，25(OH)D3可能是急性STEMI患者AOCC的促进因素。
