From the Department of Anaesthesiology, Stavanger University Hospital, Norway (T.A.).
Research Institute of Internal Medicine, the National Hospital (T.U., P.A., A.E.M.), University of Oslo, Norway.
Arterioscler Thromb Vasc Biol. 2019 Nov;39(11):2402-2410. doi: 10.1161/ATVBAHA.119.312633. Epub 2019 Sep 26.
The chemokine CXCL16 (C-X-C motif ligand 16) is a scavenger receptor for OxLDL (oxidized low-density lipoproteins) and involved in inflammation at sites of atherosclerosis. This study aimed to investigate the association of CXCL16 with clinical outcome in patients with acute coronary syndrome. Approach and Results: Serial measurements of CXCL16 were performed in a subgroup of 5142 patients randomized in the PLATO trial (Platelet Inhibition and Patient Outcome). Associations between CXCL16 and a composite of cardiovascular death, spontaneous myocardial infarction or stroke, and the individual components were assessed by multivariable Cox regression analyses. The hazard ratio per 50% increase in admission levels of CXCL16 analyzed as continuous variable was 1.64 (95% CI, 1.44-1.88), <0.0001. This association remained statistically significant after adjustment for randomized treatment, clinical variables, CRP (C-reactive protein), leukocytes, cystatin C, NT-proBNP (N-terminal pro-brain natriuretic peptide), troponin T, GDF-15 (growth differentiation factor 15), and other biomarkers; hazard ratio 1.23 (1.05-1.45), =0.0126. The admission level of CXCL16 was independently associated with cardiovascular death (1.50 [1.17-1.92], =0.0014) but not with ischemic events alone, in fully adjusted analyses. No statistically independent association was found between CXCL16 measured at 1 month, or change in CXCL16 from admission to 1 month, and clinical outcomes.
In patients with acute coronary syndrome, admission level of CXCL16 is independently related to adverse clinical outcomes, mainly driven by an association to cardiovascular death. Thus, CXCL16 measurement may enhance risk stratification in patients with this condition.
URL: http://www.clinicaltrials.gov. Unique identifier: NCT00391872.
趋化因子 CXCL16（C-X-C 基序配体 16）是 OxLDL（氧化低密度脂蛋白）的清道夫受体，参与动脉粥样硬化部位的炎症反应。本研究旨在探讨 CXCL16 与急性冠状动脉综合征患者临床结局的相关性。
在 PLATO 试验（血小板抑制和患者结局）中随机分组的 5142 例患者亚组中进行了 CXCL16 的系列测量。通过多变量 Cox 回归分析评估了 CXCL16 与心血管死亡、自发性心肌梗死或中风的复合终点以及各组成部分之间的相关性。作为连续变量分析时，入院时 CXCL16 水平每增加 50%，风险比为 1.64（95%CI，1.44-1.88），<0.0001。在调整随机治疗、临床变量、CRP（C 反应蛋白）、白细胞、胱抑素 C、NT-proBNP（N 端脑利钠肽前体）、肌钙蛋白 T、GDF-15（生长分化因子 15）和其他生物标志物后，这种相关性仍然具有统计学意义；风险比 1.23（1.05-1.45），=0.0126。入院时 CXCL16 水平与心血管死亡独立相关（1.50 [1.17-1.92]，=0.0014），但在完全调整的分析中与单纯缺血事件无关。在急性冠状动脉综合征患者中，1 个月时测量的 CXCL16 或从入院到 1 个月时 CXCL16 的变化与临床结局之间未发现统计学上独立的相关性。
在急性冠状动脉综合征患者中，入院时 CXCL16 水平与不良临床结局独立相关，主要与心血管死亡有关。因此，CXCL16 测量可能会增强这种情况下的风险分层。
