Intermountain Medical Center, Murray, UT; University of Utah, Salt Lake City, UT.
Intermountain Medical Center, Murray, UT.
Am Heart J. 2018 Aug;202:27-32. doi: 10.1016/j.ahj.2018.04.003. Epub 2018 Apr 6.
GlycA is an inflammatory marker that is raised in patients with cardiometabolic diseases and associated with cardiovascular (CV) events. We sought to determine if GlycA adds independent value to hsCRP for CV risk prediction.
Patients in the Intermountain Heart Collaborative Study who underwent coronary angiography and had plasma GlycA and hsCRP levels were studied (n = 2996). Patients were followed for 7.0 ± 2.8 years. GlycA and hsCRP were moderately correlated (r = 0.46, P < .0001). GlycA and hsCRP concentrations were stratified into high and low categories by their median values. Multivariable cox hazard regression was utilized to determine the associations of GlycA quartiles, as well as high and low categories of GlycA and hsCRP, with major adverse cardiovascular events (MACE) defined as the composite of death, myocardial infarction (MI), heart failure (HF) hospitalization, and stroke.
The highest GlycA quartile was associated with future MACE [HR: 1.43; 95% CI: 1.22-1.69; P < .0001]. Patients with high GlycA and high hsCRP had more diabetes, hyperlipidemia, hypertension, HF, renal failure and MI, but not coronary artery disease. High GlycA and hsCRP (H/H) versus low GlycA and hsCRP (L/L) was associated with MACE, death and HF hospitalization, but not MI or stroke. Combined MACE rates were 33.5%, 41.3%, 35.7% and 49.1% for L/L, L/H, H/L and H/H categories of GlycA/hsCRP, respectively (P-trend < .0001). The interaction between GlycA and hsCRP was significant for the outcome of death (P = .03).
In this study, levels of GlycA and hsCRP were independent and additive markers of risk for MACE, death and HF hospitalization.
GlycA 是一种炎症标志物，在患有心脏代谢疾病的患者中升高，并与心血管 (CV) 事件相关。我们试图确定 GlycA 是否为 hsCRP 对 CV 风险预测提供了独立的价值。
研究了在 Intermountain Heart 协作研究中接受冠状动脉造影检查且血浆 GlycA 和 hsCRP 水平可检测的患者（n=2996）。对患者进行了 7.0±2.8 年的随访。GlycA 和 hsCRP 中度相关（r=0.46，P<0.0001）。根据中位数将 GlycA 和 hsCRP 浓度分为高和低两类。多变量 Cox 风险回归用于确定 GlycA 四分位数以及 GlycA 和 hsCRP 的高和低类别与主要不良心血管事件 (MACE) 的相关性，MACE 定义为死亡、心肌梗死 (MI)、心力衰竭 (HF) 住院和中风的综合指标。
GlycA 四分位最高者与未来 MACE 相关[HR：1.43；95%CI：1.22-1.69；P<0.0001]。高 GlycA 和高 hsCRP 的患者有更多的糖尿病、高脂血症、高血压、HF、肾功能衰竭和 MI，但没有冠心病。高 GlycA 和 hsCRP（H/H）与低 GlycA 和 hsCRP（L/L）相比，与 MACE、死亡和 HF 住院相关，但与 MI 或中风无关。GlycA/hsCRP 的 L/L、L/H、H/L 和 H/H 类别组合的 MACE 发生率分别为 33.5%、41.3%、35.7%和 49.1%（P 趋势<.0001）。GlycA 和 hsCRP 之间的交互作用对死亡结局有显著意义（P=0.03）。
在这项研究中，GlycA 和 hsCRP 水平是 MACE、死亡和 HF 住院的独立且可叠加的风险标志物。
