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Galectin-3 与 hs-CRP 与非 ST 段抬高型心肌梗死合并预先存在的心房颤动的临床转归的关系。

The Association between Galectin-3 and hs-CRP and the Clinical Outcome after Non-ST-Elevation Myocardial Infarction with Preexisting Atrial Fibrillation.

机构信息

Department of Internal Medicine - Cardiology, Medical Faculty, University of Nis, Bulevar dr Zorana Djindjica 81, Nis, Serbia.

Clinic for Cardiovascular Diseases, Clinical Centre Nis, Bulevar dr Zorana Djindjica 48, Nis, Serbia.

出版信息

Sci Rep. 2017 Nov 8;7(1):15106. doi: 10.1038/s41598-017-15265-0.

Abstract

Increased galectin-3 plasma concentration has been linked to an unfavorable outcome in patients with heart failure or atrial fibrillation (AF). There are no published data about the prognostic utility of galectin-3 and high-sensitivity C-reactive protein (hs-CRP) for long-term clinical outcome in the Non-ST elevation acute myocardial infarction (NSTEMI) patients with preexisting AF. Thirty-two patients with the first acute NSTEMI and preexisting AF and 22 patients without preexisting AF, were prospectively followed for fifteen months. Patients with AF had significantly higher galectin-3 plasma levels (p < 0.05) and hs-CRP concentration (p < 0.01), compared with patients without AF. Galectin-3 plasma concentration was not a significant covariate of the composite outcomes (p = 0.913). Patients with high hs-CRP (above 4.55 mg/L) showed 2.5 times increased risk (p < 0.05) of the composite outcome occurrence (p < 0.05). Besides, three-vessel coronary artery disease, creatinine serum level, and creatinine clearance were significant covariates (p < 0.05; p < 0.05; p < 0.01) of the composite outcome, respectively. Creatinine clearance, solely, has been shown to be an independent predictor of unfavorable prognosis after a 15-month follow-up. Galectin-3 and hs-CRP plasma levels were elevated in NSTEMI patients with AF, but with differential predictive value for an unfavorable clinical outcome. Only hs-CRP was associated with increased risk of composite outcome occurrence.

摘要

在心力衰竭或心房颤动(AF)患者中,血浆半乳糖凝集素-3 浓度升高与不良预后相关。目前尚无关于半乳糖凝集素-3 和高敏 C 反应蛋白(hs-CRP)在伴有预先存在 AF 的非 ST 段抬高型急性心肌梗死(NSTEMI)患者中的长期临床预后的预测价值的发表数据。前瞻性随访了 32 例首次急性 NSTEMI 和预先存在 AF 的患者和 22 例无预先存在 AF 的患者,随访时间为 15 个月。与无 AF 的患者相比,AF 患者的半乳糖凝集素-3 血浆水平(p<0.05)和 hs-CRP 浓度(p<0.01)显著更高。半乳糖凝集素-3 血浆浓度不是复合结局的显著协变量(p=0.913)。hs-CRP 升高(高于 4.55mg/L)的患者发生复合结局的风险增加 2.5 倍(p<0.05)。此外,三血管冠状动脉疾病、血清肌酐水平和肌酐清除率分别是复合结局的显著协变量(p<0.05;p<0.05;p<0.01)。仅肌酐清除率在 15 个月随访后显示为不良预后的独立预测因子。NSTEMI 合并 AF 患者的半乳糖凝集素-3 和 hs-CRP 血浆水平升高,但对不良临床结局的预测价值不同。只有 hs-CRP 与复合结局发生的风险增加相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8863/5678137/8f759de0227d/41598_2017_15265_Fig1_HTML.jpg

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