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多标志物分析在急性心肌梗死患者中的应用。

Multibiomarker analysis in patients with acute myocardial infarction.

机构信息

Department of Cardiology, Paracelsus Medical University, Salzburg, Austria.

Division of Cardiology, Angiology, Pneumology and Intensive MedicalCare, Department of Internal Medicine I, Friedrich-Schiller-University Jena, Jena, Germany.

出版信息

Eur J Clin Invest. 2017 Sep;47(9):638-648. doi: 10.1111/eci.12785. Epub 2017 Jul 28.

Abstract

BACKGROUND

Novel biomarkers representing different pathobiological pathways and their role in patients with acute myocardial infarction (AMI) were studied.

METHODS

We retrospectively analysed serum levels of soluble suppression of tumorigenicity (sST2), growth-differentiation factor-15 (GDF-15), soluble urokinase plasminogen activator receptor (suPAR), heart-type fatty acid-binding protein (H-FABP) and plasma fetuin A in blood of patients with AMI (STEMI, n = 61; NSTEMI, n = 57) compared to controls with excluded coronary artery disease (n = 76). Furthermore, detailed correlation analysis was performed.

RESULTS

Compared with controls, in patients with STEMI and NSTEMI higher levels expressed as median of sST2 in pg/mL (STEMI: 13210·9, NSTEMI: 11989·1, control: 5248; P < 0·001), GDF-15 in pg/mL (STEMI: 818·8, NSTEMI 677·5, control 548·6; P < 0·001), suPAR in pg/mL (STEMI: 3461·1, NSTEMI: 3466·7, control: 2463·6; P < 0·001), H-FABP in ng/mL (STEMI: 5·8, NSTEMI: 5·4, control: 0·0; P < 0·001) and lower plasma fetuin A levels in μg/mL (STEMI: 95, NSTEMI: 54, control: 116·6; P < 0·001) were detected. Correlation analysis found clinical and biochemical parameters such as ejection fraction, length of hospital stay, creatine kinase, NT-proBNP and hs Troponin T levels as well as inflammatory markers (CRP, leucocytes) to be significantly correlated with novel biomarkers.

CONCLUSION

Plasma levels of novel biomarkers were significantly elevated (sST2, GDF-15, H-FABP, suPAR) or inversely downregulated (fetuin A) in patients with AMI compared to a control group with excluded coronary artery disease. Significant correlations with various clinical parameters and standard biochemical markers were found.

摘要

背景

研究了代表不同病理生物学途径的新型生物标志物及其在急性心肌梗死(AMI)患者中的作用。

方法

我们回顾性分析了 61 例 ST 段抬高型心肌梗死(STEMI)和 57 例非 ST 段抬高型心肌梗死(NSTEMI)患者及 76 例排除冠状动脉疾病的对照组患者的血清可溶性抑制肿瘤发生(sST2)、生长分化因子 15(GDF-15)、可溶性尿激酶型纤溶酶原激活物受体(suPAR)、心脏型脂肪酸结合蛋白(H-FABP)和血浆胎球蛋白 A 水平。此外,还进行了详细的相关性分析。

结果

与对照组相比,STEMI 和 NSTEMI 患者的 sST2(STEMI:13210·9pg/mL,NSTEMI:11989·1pg/mL,对照组:5248pg/mL;P<0·001)、GDF-15(STEMI:818·8pg/mL,NSTEMI:677·5pg/mL,对照组:548·6pg/mL;P<0·001)、suPAR(STEMI:3461·1pg/mL,NSTEMI:3466·7pg/mL,对照组:2463·6pg/mL;P<0·001)、H-FABP(STEMI:5·8ng/mL,NSTEMI:5·4ng/mL,对照组:0·0ng/mL;P<0·001)水平升高,血浆胎球蛋白 A(STEMI:95μg/mL,NSTEMI:54μg/mL,对照组:116.6μg/mL;P<0·001)水平降低。相关性分析发现,射血分数、住院时间、肌酸激酶、NT-proBNP 和高敏肌钙蛋白 T 水平等临床和生化参数以及炎症标志物(CRP、白细胞)与新型生物标志物显著相关。

结论

与排除冠状动脉疾病的对照组相比,AMI 患者的新型生物标志物(sST2、GDF-15、H-FABP、suPAR)水平显著升高,或(胎球蛋白 A)水平显著降低。与各种临床参数和标准生化标志物均存在显著相关性。

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