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外周循环中的嗜酸性粒细胞计数与冠状动脉疾病有关。

Eosinophils count in peripheral circulation is associated with coronary artery disease.

机构信息

Department of Cardiovascular Medicine, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, China.

Department of Neurology, Xi'an Gaoxin Hospital, China.

出版信息

Atherosclerosis. 2019 Jul;286:128-134. doi: 10.1016/j.atherosclerosis.2019.05.027. Epub 2019 May 28.

Abstract

BACKGROUND AND AIMS

Allergic asthma can accelerate atherosclerosis, a disease in which plaque is deposited onto arterial walls and that may lead to coronary artery disease (CAD). Eosinophils are the most important effector cells in allergic asthma and are likely to become novel biomarkers for risk stratification of patients with CAD, but the relationship between eosinophil count and CAD remains unclear. We aimed to evaluate this relationship and the use of eosinophils in predicting CAD.

METHODS

A total of 5287 patients who underwent coronary angiography were recruited. Their biochemical parameters, including eosinophil count, were measured and their correlation with the severity of coronary artery stenosis, as quantified by the Gensini score system, was evaluated.

RESULTS

The percentages of eosinophils in leukocytes (PELs) were lower in CAD patients (p < 0.001), and had a significant negative correlation with Gensini scores (r = -0.112, p < 0.001). PELs were also significantly lower in acute myocardial infarction patients (p < 0.001). After adjusting for baseline differences, low PELs remained strongly associated with severe CAD and acute coronary arterial thrombotic event. Receiver-operating characteristic curve analysis showed that combining PELs with traditional risk factors in predictive models for CAD severity (z = 4.470, p < 0.001) or acute coronary arterial thrombotic event (z = 9.435, p < 0.001) improved the predictive capabilities of those models.

CONCLUSIONS

PELs, at least in patients undergoing coronary angiography, may be strongly related to the subtype and severity of CAD and, therefore, eosinophil count may be an accurate and independent biomarker to predict CAD severity and acute coronary arterial thrombotic events.

摘要

背景与目的

过敏性哮喘可加速动脉粥样硬化,即斑块在动脉壁上沉积并可能导致冠心病(CAD)的发生。嗜酸性粒细胞是过敏性哮喘中最重要的效应细胞,可能成为 CAD 患者风险分层的新型生物标志物,但嗜酸性粒细胞计数与 CAD 的关系尚不清楚。我们旨在评估这种关系以及嗜酸性粒细胞在预测 CAD 中的作用。

方法

共纳入 5287 例行冠状动脉造影的患者。测量其生化参数,包括嗜酸性粒细胞计数,并评估其与冠状动脉狭窄严重程度(以 Gensini 评分系统定量)的相关性。

结果

CAD 患者白细胞中的嗜酸性粒细胞百分比(PELs)较低(p<0.001),且与 Gensini 评分呈显著负相关(r=-0.112,p<0.001)。急性心肌梗死患者的 PELs 也明显较低(p<0.001)。在校正基线差异后,低 PELs 仍与严重 CAD 和急性冠状动脉血栓形成事件密切相关。受试者工作特征曲线分析表明,将 PELs 与传统危险因素结合用于预测 CAD 严重程度(z=4.470,p<0.001)或急性冠状动脉血栓形成事件(z=9.435,p<0.001)的预测模型中,可提高这些模型的预测能力。

结论

至少在接受冠状动脉造影的患者中,PELs 可能与 CAD 的亚型和严重程度密切相关,因此嗜酸性粒细胞计数可能是预测 CAD 严重程度和急性冠状动脉血栓形成事件的准确且独立的生物标志物。

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