Department of Cardiovascular Medicine, First Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China.
Department of Cardiovascular Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Sci Rep. 2018 Jun 18;8(1):9294. doi: 10.1038/s41598-018-27639-z.
The double-stranded DNA (dsDNA) which is scaffold of neutrophil extracellular traps (NETs) has been reported to be associated with the occurrence of major adverse cardiovascular events (MACEs) in patients with coronary atherosclerosis. However, the relationship between the dsDNA and the occurrence of MACEs in patients with ST-segment elevated myocardial infarction (STEMI) remains unclear. In this study, 142 consecutive STEMI patients were admitted to medical institutions. Blood from the infarct-related coronary artery (ICA) and peripheral artery (PA) were obtained during percutaneous coronary intervention. Clinical follow-up was performed to analyze the occurrence of MACEs. Patients were divided into low ds-DNA group and high dsDNA group according to the cut-off value of ICA dsDNA. Mean follow-up time was 24.52 months in low dsDNA group and 25.71 months in high dsDNA group. dsDNA in the ICA was significantly higher than in the PA (p = 0.038) and Spearman's correlation analysis showed that they were positively correlated (r = 0.758; p < 0.01). ICA dsDNA correlated negatively with ST-segment resolution (r = -0.227; p = 0.007). The long-term MACEs rate was higher in high dsDNA group than low dsDNA group (23.7 vs. 6.7%, p = 0.015). The ICA dsDNA (OR 7.43 95% CI 1.25 to 4.07, p = 0.027), Killip class (OR 5.01 95% CI 1.11 to 4.37, p = 0.025), BMI (OR 1.36 95% CI 1.06 to 1.7, p = 0.016) and white blood cell count (OR 1.27 95% CI 1.03 to 1.57, p = 0.024) were independent predictors of the occurrence of MACEs.
双链 DNA（dsDNA）是中性粒细胞胞外诱捕网（NETs）的支架，据报道与冠状动脉粥样硬化患者发生主要不良心血管事件（MACEs）有关。然而，dsDNA 与 ST 段抬高型心肌梗死（STEMI）患者发生 MACEs 的关系尚不清楚。本研究纳入了 142 例连续 STEMI 患者，在经皮冠状动脉介入治疗期间从梗死相关冠状动脉（ICA）和外周动脉（PA）获取血液。进行临床随访以分析 MACEs 的发生情况。根据 ICA dsDNA 的截断值将患者分为低 ds-DNA 组和高 dsDNA 组。低 dsDNA 组的平均随访时间为 24.52 个月，高 dsDNA 组为 25.71 个月。ICA 中的 dsDNA 明显高于 PA（p=0.038），Spearman 相关性分析显示它们呈正相关（r=0.758；p<0.01）。ICA dsDNA 与 ST 段分辨率呈负相关（r=-0.227；p=0.007）。高 dsDNA 组的长期 MACEs 发生率高于低 dsDNA 组（23.7%比 6.7%，p=0.015）。ICA dsDNA（OR 7.43，95%CI 1.25 至 4.07，p=0.027）、Killip 分级（OR 5.01，95%CI 1.11 至 4.37，p=0.025）、BMI（OR 1.36，95%CI 1.06 至 1.7，p=0.016）和白细胞计数（OR 1.27，95%CI 1.03 至 1.57，p=0.024）是 MACEs 发生的独立预测因子。
