Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University, Salzburg, Austria.
University Heart Center Lübeck, Medical Clinic II, University Hospital Schleswig-Holstein and German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Lübeck, Germany.
Sci Rep. 2019 Dec 4;9(1):18367. doi: 10.1038/s41598-019-54937-x.
Syndecan-1 (sdc1) is a surface protein part of the endothelial glycocalyx (eGC). Soluble sdc1 is derived from shedding and indicates damaged eGC. We assessed the predictive value of plasma sdc1 concentrations for future cardiovascular events in acute reperfused ST-segment elevation myocardial infarction (STEMI) patients. A total of 206 patients admitted for STEMI were included in this study (29% female; age 65 ± 12 years) and followed-up for six months. Plasma samples were obtained post-intervention and analyzed for sdc1 by Enzyme-linked Immunosorbent Assay (ELISA). Primary outcome was six-month-mortality. Sdc1 did not correlate with biomarkers such as creatine kinase (CK) (r = 0.11; p = 0.01) or troponin (r = -0.12; p = 0.09), nor with infarct size (r = -0.04; p = 0.67) and myocardial salvage index (r = 0.11; p = 0.17). Sdc-1 was associated with mortality (changes per 100 ng/mL sdc-1 concentration; HR 1.08 95% 1.03-1.12; p = 0.001). An optimal cut-off was calculated at >120 ng/mL. After correction for known risk factors sdc1 >120 ng/mL was independently associated with mortality after 6 months. In our study, sdc1 is independently associated with six-month-mortality after STEMI. Combining clinical evaluation and different biomarkers assessing both infarct-related myocardial injury and systemic stress response might improve the accuracy of predicting clinical prognosis in STEMI patients.
硫酸乙酰肝素蛋白聚糖 1（sdc1）是血管内皮糖萼（eGC）的表面蛋白部分。可溶性 sdc1 来自于脱落，表明 eGC 受损。我们评估了急性再灌注 ST 段抬高型心肌梗死（STEMI）患者血浆 sdc1 浓度对未来心血管事件的预测价值。本研究共纳入 206 例 STEMI 患者（女性占 29%；年龄 65±12 岁），并进行了 6 个月的随访。介入后采集血浆样本，通过酶联免疫吸附试验（ELISA）分析 sdc1。主要结局为 6 个月死亡率。sdc1 与肌酸激酶（CK）（r=0.11；p=0.01）或肌钙蛋白（r=-0.12；p=0.09）等生物标志物均无相关性，也与梗死面积（r=-0.04；p=0.67）和心肌挽救指数（r=-0.11；p=0.17）无关。sdc-1 与死亡率相关（每增加 100ng/ml sdc-1 浓度的变化；HR 1.08 95%1.03-1.12；p=0.001）。计算出最佳截断值为>120ng/ml。校正已知危险因素后，sdc1>120ng/ml 与 6 个月后的死亡率独立相关。在我们的研究中，sdc1 与 STEMI 后 6 个月的死亡率独立相关。结合临床评估和不同的生物标志物，评估梗死相关心肌损伤和全身应激反应，可能会提高预测 STEMI 患者临床预后的准确性。
