Takagi Wataru, Miyoshi Toru, Doi Masayuki, Okawa Keisuke, Nosaka Kazumasa, Nishibe Tomoyuki, Matsuo Naoaki, Hirohata Satoshi, Ito Hiroshi
Department of Cardiology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.
BMC Cardiovasc Disord. 2017 Oct 10;17(1):258. doi: 10.1186/s12872-017-0691-2.
Adipocyte fatty acid-binding protein (A-FABP) is expressed in both adipocytes and macrophages. Recent studies have shown that A-FABP is secreted by adipocytes and that the A-FABP concentration is associated with obesity, insulin resistance, and atherosclerosis. We have reported that the coronary atherosclerotic burden is associated with the serum A-FABP concentration. In the present study, we investigated whether the serum A-FABP concentration is associated with prognosis in patients with stable angina pectoris who have undergone percutaneous coronary intervention (PCI).
This was a prospective single-center trial. In total, 130 patients with stable angina pectoris undergoing their first PCI were enrolled from August 2008 to July 2010 at Kagawa Prefectural Central Hospital. The primary endpoints were cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, revascularization, and hospitalization for heart failure.
During the follow-up (median, 50 months; interquartile range, 23-66 months), 49 cardiovascular events occurred. Kaplan-Meier analysis showed that the cumulative incidence of the primary endpoints in the high A-FABP group (median A-FABP concentration of ≥ 18.6 ng/ml) was greater than that in the low A-FABP group. Cox analysis showed that the A-FABP concentration was an independent predictor of cardiovascular events adjusted for age and the presence of multi-vessel disease (hazard ratio, 1.03; 95% confidence interval, 1.01-1.04; p = 0.01).
The serum A-FABP concentration is associated with prognosis in patients with stable angina undergoing PCI, suggesting that the serum A-FABP concentration could be useful for risk assessment of secondary prevention.
UMIN Clinical Trials Registry UMIN000029283 (registration date: September 25, 2017), retrospectively registered.
脂肪细胞脂肪酸结合蛋白(A-FABP)在脂肪细胞和巨噬细胞中均有表达。近期研究表明,A-FABP由脂肪细胞分泌,且A-FABP浓度与肥胖、胰岛素抵抗和动脉粥样硬化相关。我们曾报道冠状动脉粥样硬化负担与血清A-FABP浓度相关。在本研究中,我们调查了血清A-FABP浓度是否与接受经皮冠状动脉介入治疗(PCI)的稳定型心绞痛患者的预后相关。
这是一项前瞻性单中心试验。2008年8月至2010年7月,共有130例首次接受PCI的稳定型心绞痛患者在香川县立中央医院入组。主要终点为心血管死亡、非致死性心肌梗死、非致死性卒中、血运重建以及因心力衰竭住院。
在随访期间(中位时间为50个月;四分位间距为23 - 66个月),发生了49例心血管事件。Kaplan-Meier分析显示,高A-FABP组(中位A-FABP浓度≥18.6 ng/ml)的主要终点累积发生率高于低A-FABP组。Cox分析显示,校正年龄和多支血管病变的存在后,A-FABP浓度是心血管事件的独立预测因子(风险比为1.03;95%置信区间为1.01 - 1.04;p = 0.01)。
血清A-FABP浓度与接受PCI的稳定型心绞痛患者的预后相关,提示血清A-FABP浓度可能有助于二级预防的风险评估。
UMIN临床试验注册中心UMIN000029283(注册日期:2017年9月25日),回顾性注册。