Ji Shuya, Kou Wenxin, Luan Peipei, Jian Weixia, Zhuang Jianhui, Xu Xiaopeng, Zhao Yifan, Li Hailing, Peng Wenhui
Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072 China.
Department of Endocrinology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200000, China.
Ann Transl Med. 2020 Apr;8(7):479. doi: 10.21037/atm.2020.03.29.
Our previous study showed that visceral adipose tissue-derived serpin (vaspin) was an independent predictor of coronary artery disease (CAD). Further, plasma vaspin levels in patients with unstable angina pectoris were lower than those in patients with stable angina pectoris. In this study, we investigated the prognostic relevance of plasma vaspin levels in patients with CAD and non-CAD.
It was a retrospective observational study. A total of 197 patients with chest pain were enrolled, of which 88 patients with CAD and 109 patients with non-CAD were confirmed by angiography. Plasma vaspin levels and clinical parameters were measured at baseline. Incidence of major adverse cardiac event (MACE) was determined on follow-up.
One hundred eighty-nine patients were successfully followed up for 5 years, of which 63 patients experienced MACEs. Patients with low vaspin levels (<0.385 ng/mL) experienced a higher incidence of MACE as compared to patients with high vaspin levels (>0.385 ng/mL) (42.55% 24.21%, respectively; P=0.007). In both CAD and non-CAD groups, patients with high vaspin levels showed improvement in left ventricular ejection fraction. Kaplan Meier survival curves showed that patients with low vaspin levels had an obviously higher timing of incidence of MACE in the whole population (P=0.006) and in the non-CAD subgroup (P=0.009); however, the trend was not significant in the CAD subgroup. On multivariate analyses, plasma vaspin level was found to be an independent predictor of MACE, particularly in the non-CAD group.
Plasma vaspin may be a useful biomarker for prediction of MACE in patients with chest pain.
我们之前的研究表明，内脏脂肪组织衍生的丝氨酸蛋白酶抑制剂（vaspin）是冠状动脉疾病（CAD）的独立预测因子。此外，不稳定型心绞痛患者的血浆vaspin水平低于稳定型心绞痛患者。在本研究中，我们调查了CAD和非CAD患者血浆vaspin水平的预后相关性。
这是一项回顾性观察研究。共纳入197例胸痛患者，其中88例CAD患者和109例非CAD患者经血管造影确诊。在基线时测量血浆vaspin水平和临床参数。随访时确定主要不良心脏事件（MACE）的发生率。
189例患者成功随访5年，其中63例发生MACE。与vaspin水平高（>0.385 ng/mL）的患者相比，vaspin水平低（<0.385 ng/mL）的患者发生MACE的发生率更高（分别为42.55%和24.21%；P=0.007）。在CAD组和非CAD组中，vaspin水平高的患者左心室射血分数均有所改善。Kaplan Meier生存曲线显示，vaspin水平低的患者在总体人群（P=0.006）和非CAD亚组（P=0.009）中发生MACE的时间明显更早；然而，在CAD亚组中该趋势不显著。多因素分析发现，血浆vaspin水平是MACE的独立预测因子，尤其是在非CAD组。
血浆vaspin可能是预测胸痛患者MACE的有用生物标志物。
