Leocádio Paola, Menta Penélope, Dias Melissa, Fraga Júlia, Goulart Alessandra, Santos Itamar, Lotufo Paulo, Bensenor Isabela, Alvarez-Leite Jacqueline
Departamento de Bioquímica e Imunologia - Universidade Federal de Minas Gerais, Belo Horizonte, MG - Brasil.
Centro de Pesquisa Clínica e Epidemiológica do Hospital Universitário da Universidade de São Paulo, São Paulo, SP - Brasil.
Arq Bras Cardiol. 2020 May-Jun;114(3):507-514. doi: 10.36660/abc.20190035.
Several markers have been evaluated for a potential impact on clinical decisions or mortality prediction in acute coronary syndrome (ACS), including Netrin-1 and IL-1β that have been associated with cardiovascular disease.
Our study examined the prognostic value of Netrin-1 and IL-1β in patients with ACS (2-year follow-up).
We evaluate Netrin-1, IL-1β and other risk factors in the serum sample of 803 patients. Kaplan-Meier curves and Cox regression were used for the analysis of all-cause mortality, cardiovascular mortality, and a combined outcome of fatal myocardial infarction (MI) or new non-fatal MI, considering p-value < 0.05.
There were 115 deaths from all causes, 78 deaths due to cardiovascular causes and 67 events in combined outcomes. Netrin-1 levels above the median (>44.8 pg/mL) were associated with a worse prognosis (all-cause mortality and cardiovascular mortality) in elderly females, even after model adjustment (HR: 2.08, p = 0.038 and HR: 2.68, p = 0.036). IL-1β levels above the median (>13.4 pg/mL) in elderly females were associated with increased risk of all outcomes after adjustment (all-cause mortality - HR: 2.03, p = 0.031; cardiovascular mortality - HR: 3.01, p = 0.013; fatal MI or new non-fatal MI - HR: 3.05, p = 0.029). For males, no associations were observed between Netrin-1 or IL-1β and outcomes.
High serum levels of Netrin-1 and IL-1β showed significant association with worse prognosis in elderly females. They may be useful as prognostic indicators in ACS. (Arq Bras Cardiol. 2020; 114(3):507-514).
已经对几种标志物进行了评估，以确定其对急性冠状动脉综合征（ACS）临床决策或死亡率预测的潜在影响，包括与心血管疾病相关的Netrin-1和白细胞介素-1β（IL-1β）。
我们的研究探讨了Netrin-1和IL-1β在ACS患者中的预后价值（随访2年）。
我们评估了803例患者血清样本中的Netrin-1、IL-1β和其他危险因素。采用Kaplan-Meier曲线和Cox回归分析全因死亡率、心血管死亡率以及致命性心肌梗死（MI）或新发非致命性MI的综合结局，以p值<0.05为有统计学意义。
共有115例全因死亡，78例心血管原因死亡，67例综合结局事件。即使在模型调整后，老年女性中Netrin-1水平高于中位数（>44.8 pg/mL）与预后较差（全因死亡率和心血管死亡率）相关（风险比[HR]：2.08，p = 0.038；HR：2.68，p = 0.036）。老年女性中IL-1β水平高于中位数（>13.4 pg/mL）在调整后与所有结局风险增加相关（全因死亡率-HR：2.03，p = 0.031；心血管死亡率-HR：3.01，p = 0.013；致命性MI或新发非致命性MI-HR：3.05，p = 0.029）。对于男性，未观察到Netrin-1或IL-1β与结局之间存在关联。
血清Netrin-1和IL-1β水平升高与老年女性预后较差显著相关。它们可能作为ACS的预后指标。（《巴西心脏病学杂志》。2020年；114(3):507-514）
