Department of Cardiology, Shanghai East Hospital, Tongji University, Shanghai, China.
Department of Cardiology, Tongji Hospital, Tongji University, Shanghai, China.
Metabolism. 2020 Oct;111:154323. doi: 10.1016/j.metabol.2020.154323. Epub 2020 Jul 27.
Proprotein convertase subtilisin/kexin (PCSK) family member 3 (FURIN) has been suggested to be involved in the development of atherosclerosis. The aim of this study was to investigate the prognostic implication of FURIN in patients after acute myocardial infarction (AMI).
This prospective study analyzed data from a total of 1312 consecutive patients hospitalized with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction from August 2013 to June 2016. FURIN levels were analyzed in plasma obtained from AMI patients.
The study included 1312 AMI patients. The patient population was predominantly male (63%) with a median age of 66 years (IQR: 19 years), and 59% were STEMI patients. During a follow-up of 2 years, 117 patients died, and 377 patients reached the combined endpoints of major adverse cardiac events (MACE). Patients with elevated FURIN levels had increased risk of MACE, all-cause mortality, recurrent MI and hospitalization for HF (log-rank test, p < 0.0001). After adjusting for clinical risk factors and established markers, the association of FURIN concentrations with the risk of MACE and its individual components and cardiovascular death was statistically significant in the higher tertile of FURIN concentrations. After the addition of FURIN to the models, FURIN showed additive prognostic significance for 2-year clinical outcomes. Variable importance plots of the models showed that FURIN was of high importance to predict both occurrence of MACE and all-cause mortality.
We found that FURIN was associated with all-cause mortality and recurrent cardiovascular events in AMI patients independent of conventional risk factors and established markers.
丝氨酸蛋白酶原亚基 kexin 型蛋白酶 3（PCSK）家族成员 3（FURIN）已被认为参与动脉粥样硬化的发展。本研究旨在探讨 FURIN 在急性心肌梗死（AMI）患者中的预后意义。
这项前瞻性研究分析了 2013 年 8 月至 2016 年 6 月期间因 ST 段抬高型心肌梗死（STEMI）和非 ST 段抬高型心肌梗死住院的 1312 例连续患者的数据。分析了来自 AMI 患者的血浆中的 FURIN 水平。
该研究纳入了 1312 例 AMI 患者。患者人群以男性为主（63%），中位年龄为 66 岁（IQR：19 岁），59%为 STEMI 患者。在 2 年的随访期间，117 例患者死亡，377 例患者达到主要不良心脏事件（MACE）的联合终点。FURIN 水平升高的患者发生 MACE、全因死亡率、复发性 MI 和心力衰竭住院的风险增加（对数秩检验，p<0.0001）。在调整临床危险因素和已建立的标志物后，FURIN 浓度与 MACE 及其各组成部分和心血管死亡的风险之间的关联在 FURIN 浓度较高的三分位中具有统计学意义。在向模型中添加 FURIN 后，FURIN 对 2 年临床结局的预后意义具有附加意义。模型的变量重要性图显示，FURIN 对预测 MACE 和全因死亡率都具有重要意义。
我们发现，FURIN 与 AMI 患者的全因死亡率和复发性心血管事件相关，独立于传统危险因素和已建立的标志物。
