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晚期糖基化终末产物:晚期糖基化终末产物受体轴在冠状动脉支架再狭窄中的作用:一项前瞻性研究。

Advanced Glycation End Products:Receptors for Advanced Glycation End Products Axis in Coronary Stent Restenosis: A Prospective Study.

作者信息

Pearce Colin, Islam Naorin, Bryce Robyn, McNair Erick Donnell

机构信息

Division of Cardiology, Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.

Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.

出版信息

Int J Angiol. 2018 Dec;27(4):213-222. doi: 10.1055/s-0038-1673660. Epub 2018 Oct 29.

Abstract

This study was aimed to correlate the pre- and 6-month postpercutaneous coronary intervention (PCI) serum concentrations of advanced glycation end products (AGE), soluble receptors for advanced glycation end products (sRAGE), AGE/sRAGE ratio, and serum malondialdehyde (MDA) levels with in-stent restenosis (ISR) among patients receiving either a drug-eluting stent (DES) or a bare-metal stent (BMS).In-stent restenosis remains as an adverse outcome following PCI. Sixty consecutive nondiabetic, Caucasian male patients, diagnosed with a non-ST-elevation myocardial infarction who received either a DES or BMS via PCI, were enrolled. Baseline levels of serum AGE, sRAGE, AGE/sRAGE ratios, MDA, and angiographic parameters were determined at stenting and at 6 months. Patients with and without ISR at 6 months were compared on both baseline and 6-month biomarker levels and within stent types.The pre-PCI serum AGE levels and AGE/sRAGE ratios were higher in ISR patients compared with non-ISR patients, while the pre-PCI and post-PCI serum sRAGE levels were lower in ISR patients compared with non-ISR patients. The pre and post-PCI levels of MDA were also higher in ISR patients. Comparing stent types, relative levels of MDA between those with and without ISR at the respective time points were similar, although changes between time points appeared type specific.Post-PCI ISR correlates with low serum values of sRAGE and high serum values of AGE, MDA, and AGE/sRAGE ratio which are present at stenting. The associations of baseline AGE, sRAGE, AGE/sRAGE, and MDA levels with ISR appear consistent between stent types.

摘要

本研究旨在探讨接受药物洗脱支架(DES)或裸金属支架(BMS)的患者经皮冠状动脉介入治疗(PCI)前及术后6个月时,晚期糖基化终产物(AGE)、晚期糖基化终产物可溶性受体(sRAGE)、AGE/sRAGE比值及血清丙二醛(MDA)水平与支架内再狭窄(ISR)之间的相关性。支架内再狭窄仍是PCI后的不良后果。本研究纳入了60例连续的非糖尿病白种男性患者,这些患者被诊断为非ST段抬高型心肌梗死,并通过PCI接受了DES或BMS治疗。在置入支架时及术后6个月测定血清AGE、sRAGE、AGE/sRAGE比值、MDA的基线水平及血管造影参数。比较6个月时发生和未发生ISR的患者在基线和6个月时的生物标志物水平以及不同支架类型患者的上述指标。与未发生ISR的患者相比,发生ISR的患者PCI前血清AGE水平和AGE/sRAGE比值更高,而PCI前和PCI后血清sRAGE水平更低。发生ISR的患者PCI前后MDA水平也更高。比较支架类型,在各个时间点发生和未发生ISR的患者之间MDA的相对水平相似,尽管时间点之间的变化似乎具有支架类型特异性。PCI术后ISR与支架置入时血清sRAGE低水平以及AGE、MDA和AGE/sRAGE比值高水平相关。支架类型之间,基线AGE、sRAGE、AGE/sRAGE和MDA水平与ISR的关联似乎一致。

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