Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), SERGAS, Travesía da Choupana s/n, Santiago de Compostela, 15706 A Coruña, Spain; CIBERCV, Madrid, Spain.
CIBERCV, Madrid, Spain; Servicio de Cardiología y Unidad de Hemodinámica, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), SERGAS, Travesía da Choupana s/n, Santiago de Compostela, 15706 A Coruña, Spain.
Nutr Metab Cardiovasc Dis. 2019 Oct;29(10):1050-1060. doi: 10.1016/j.numecd.2019.06.014. Epub 2019 Jun 22.
This work aimed to compare the behavior of the advanced glycation end products (AGEs) and their soluble receptor (sRAGE) in two cohorts of patients: those with heart failure (HF) and acute coronary syndrome (ACS).
A unicentric observational clinical study was performed in 102 patients with ACS and 102 patients with chronic HF matched by age and gender. At inclusion, fluorescent AGEs were measured by quantitative fluorescence spectroscopy of plasma, and total sRAGE and endogenous secretory RAGE (esRAGE) levels were determined by enzyme-linked immunosorbent assay kits. A 5-year follow-up period was established for recording cardiac death (primary endpoint) and the incidence of non-fatal myocardial infarction or HF readmission (secondary endpoints). Higher glycation parameters were observed in HF patients, whereas no differences in sRAGE forms were found between HF and ACS cohorts, except for cRAGE, which was higher in HF. Associations between glycation parameters and sRAGE forms were observed in HF, but not in ACS. Differences were also evidenced in the long-term prognosis of each cohort: esRAGE showed an independent prognostic value for cardiac death or non-fatal cardiovascular events in HF, but none of the AGE-RAGE variables were predictors in ACS.
A different role for the AGE-RAGE axis was observed in HF and ACS. All the sRAGE forms were directly related with glycation parameters in HF, but not in ACS. The independent value of the sRAGE forms on each cardiovascular disease was supported by esRAGE being an independent predictor of bad long-term prognosis only for HF.
本研究旨在比较两组患者（心力衰竭（HF）和急性冠状动脉综合征（ACS）患者）中晚期糖基化终产物（AGEs）及其可溶性受体（sRAGE）的行为。
在 102 例 ACS 患者和 102 例慢性 HF 患者中进行了一项单中心观察性临床研究，这些患者按年龄和性别进行了匹配。在纳入时，通过定量荧光光谱法测量血浆中的荧光 AGEs，并通过酶联免疫吸附试剂盒测定总 sRAGE 和内源性分泌型 RAGE（esRAGE）水平。建立了 5 年随访期，以记录心脏死亡（主要终点）和非致死性心肌梗死或 HF 再入院（次要终点）的发生率。HF 患者的糖化参数较高，而 HF 和 ACS 队列之间的 sRAGE 形式没有差异，除了 cRAGE，HF 中较高。在 HF 中观察到糖化参数和 sRAGE 形式之间的相关性，但在 ACS 中没有观察到相关性。每个队列的长期预后也存在差异：在 HF 中，esRAGE 对心脏死亡或非致死性心血管事件具有独立的预后价值，但在 ACS 中，没有任何 AGE-RAGE 变量是预测因子。
在 HF 和 ACS 中观察到 AGE-RAGE 轴的不同作用。在 HF 中，所有 sRAGE 形式都与糖化参数直接相关，但在 ACS 中没有。esRAGE 是 HF 不良长期预后的独立预测因子，这支持了 sRAGE 形式对每种心血管疾病的独立价值。
