Tian Maozhou, Zhu Lingmin, Lin Hongyang, Lin Qiaoyan, Huang Peng, Yu Xiao, Jing Yanyan
Department of Cardiac Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shangdong 264000, P.R. China.
Department of Cardiology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shangdong 264000, P.R. China.
Oncotarget. 2017 May 13;8(43):73733-73744. doi: 10.18632/oncotarget.17852. eCollection 2017 Sep 26.
High thrombus burden, subsequent distal embolization, and myocardial no-reflow remain a large obstacle that may negate the benefits of urgent coronary revascularization in patients with ST-segment elevation myocardial infarction (STEMI). However, the biological function and clinical association of Hsp-27 with thrombus burden and clinical outcomes in patients with STEMI is not clear. Consecutive patients ( = 146) having STEMI undergoing primary percutaneous coronary intervention (pPCI) within 12 hours from the onset of symptoms were enrolled in this prospective study in the Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shangdong, P.R. China. Patients were divided into low thrombus burden and high thrombus burden groups. The present study demonstrated that patients with high-thrombus burden had higher plasma Hsp-27 levels ([32.0 ± 8.6 vs. 58.0 ± 12.3] ng/mL, < 0.001). The median value of Hsp-27 levels in all patients with STEMI was 45 ng/mL. Using the receiver operating characteristic (ROC) curve analysis, plasma Hsp-27 levels were of significant diagnostic value for high thrombus burden (AUC, 0.847; 95% CI, 0.775-0.918; < 0.01). The multivariate cox regression analysis demonstrated that Hsp-27 > 45 ng/mL (HR 2.801, 95% CI 1.296-4.789, = 0.001), were positively correlated with the incidence of major adverse cardiovascular events (MACE). Kaplan-Meier survival analysis demonstrated that MACE-free survival at 180-day follow-up was significantly lower in patients with Hsp-27 > 45 ng/mL (log rank = 10.28, < 0.001). Our data demonstrate that plasma Hsp-27 was positively correlated with high thrombus burden and the incidence of MACE in patients with STEMI who underwent pPCI.
高血栓负荷、随后的远端栓塞和心肌无复流仍然是一个巨大障碍，这可能会抵消ST段抬高型心肌梗死（STEMI）患者紧急冠状动脉血运重建的益处。然而，Hsp-27在STEMI患者中的生物学功能以及与血栓负荷和临床结局的临床关联尚不清楚。在中国山东省烟台市青岛大学附属烟台毓璜顶医院，对症状发作后12小时内接受直接经皮冠状动脉介入治疗（pPCI）的连续STEMI患者（n = 146）进行了这项前瞻性研究。患者被分为低血栓负荷组和高血栓负荷组。本研究表明，高血栓负荷患者的血浆Hsp-27水平更高（[32.0±8.6 vs. 58.0±12.3] ng/mL，P<0.001）。所有STEMI患者中Hsp-27水平的中位数为45 ng/mL。采用受试者工作特征（ROC）曲线分析，血浆Hsp-27水平对高血栓负荷具有显著诊断价值（AUC，0.847；95%CI，0.775-0.918；P<0.01）。多变量cox回归分析表明，Hsp-27>45 ng/mL（HR 2.801，95%CI 1.296-4.789，P = 0.001）与主要不良心血管事件（MACE）的发生率呈正相关。Kaplan-Meier生存分析表明，Hsp-27>45 ng/mL的患者在180天随访时无MACE生存显著降低（对数秩=10.28，P<0.001）。我们的数据表明，在接受pPCI的STEMI患者中，血浆Hsp-27与高血栓负荷和MACE发生率呈正相关。
