血浆铁调素与冠心病患者死亡风险的关联。
Associations of plasma hepcidin with mortality risk in patients with coronary artery disease.
作者信息
Li Xinrui, Ding Ding, Zhang Yuan, Su Dongfang, Wang Min, Chen Xuechen, Yang Yan, Hong Changjiang, Hu Gang, Ling Wenhua
机构信息
Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.
Department of Cardiology, General Hospital of Guangzhou Military Command of People's Liberation Army, Guangzhou, Guangdong, China.
出版信息
Oncotarget. 2017 Nov 27;8(65):109497-109508. doi: 10.18632/oncotarget.22722. eCollection 2017 Dec 12.
BACKGROUND
Increased blood hepcidin may be associated with the presence and promotion of atherosclerosis, the association of hepcidin with mortality among coronary artery disease (CAD) patients remains unknown. We sought to assess the relationship of hepcidin and all-cause and cardiovascular disease (CVD) mortality among CAD patients with and without acute coronary syndrome (ACS).
METHODS AND RESULTS
This study included 759 patients with ACS and 526 patients with stable CAD. After an average follow-up of 4.1 years, 154 deaths were recorded, 114 were due to CVD. After adjusting for CVD risk factors and inflammatory markers, the plasma hepcidin was positively associated with all-cause and CVD mortality in the ACS patients, the multivariable-adjusted hazard ratios (HRs) across tertiles of hepcidin were 1.00, 2.18 (95% CI 1.23-3.94), and 2.82 (95% CI 1.59-5.12) for all-cause mortality (=0.006), and 1.00, 2.20 (95% CI 1.12-4.05), and 2.64 (95% CI 1.41-5.65) for CVD mortality (=0.01). The C-index and net reclassification improvement when including hepcidin in traditional CVD models were 1.6% and 21.5% for all-cause mortality, 1.4% and 23.5% for CVD mortality, respectively, (<0.001).
CONCLUSIONS
Plasma hepcidin was positively associated with mortality in ACS patients. Hepcidin may be a potential biomarker for risk prediction in ACS patients.
背景
血液中铁调素水平升高可能与动脉粥样硬化的存在和发展有关，而铁调素与冠状动脉疾病（CAD）患者死亡率之间的关系尚不清楚。我们试图评估铁调素与有无急性冠状动脉综合征（ACS）的CAD患者全因死亡率和心血管疾病（CVD）死亡率之间的关系。
方法与结果
本研究纳入759例ACS患者和526例稳定型CAD患者。平均随访4.1年后，记录到154例死亡，其中114例死于CVD。在调整CVD危险因素和炎症标志物后，ACS患者血浆铁调素与全因死亡率和CVD死亡率呈正相关，铁调素三分位数的多变量调整风险比（HR）分别为：全因死亡率1.00、2.18（95%CI 1.23 - 3.94）和2.82（95%CI 1.59 - 5.12）（=0.006），CVD死亡率1.00、2.20（95%CI 1.12 - 4.05）和2.64（95%CI 1.41 - 5.65）（=0.01）。在传统CVD模型中纳入铁调素时，全因死亡率的C指数和净重新分类改善分别为1.6%和21.5%，CVD死亡率分别为1.4%和23.5%（<0.001）。
结论
血浆铁调素与ACS患者死亡率呈正相关。铁调素可能是ACS患者风险预测的潜在生物标志物。
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