Haj-Yehia Elias, Mertens Robert Werner, Kahles Florian, Rückbeil Marcia Viviane, Rau Matthias, Moellmann Julia, Biener Moritz, Almalla Mohammad, Schroeder Jörg, Giannitsis Evangelos, Katus Hugo Albert, Marx Nikolaus, Lehrke Michael
Department of Internal Medicine I-Cardiology, University Hospital Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
Department of Medical Statistics, University Hospital Aachen, Pauwelsstraße 19, 52074 Aachen, Germany.
J Clin Med. 2020 Dec 6;9(12):3952. doi: 10.3390/jcm9123952.
Recent studies have found circulating concentrations of the gastrointestinal hormone GLP-1 to be an excellent predictor of cardiovascular risk in patients with myocardial infarction. This illustrates a yet not appreciated crosstalk between the gastrointestinal and cardiovascular systems, which requires further investigation. The gut-derived hormone Peptide YY (PYY) is secreted from the same intestinal L-cells as GLP-1. Relevance of PYY in the context of cardiovascular disease has not been explored. In this study, we aimed to investigate PYY serum concentrations in patients with acute myocardial infarction and to evaluate their association with cardiovascular events.
PYY levels were assessed in 834 patients presenting with acute myocardial infarction (553 Non-ST-Elevation Myocardial Infarction (NSTEMI) and 281 ST-Elevation Myocardial Infarction (STEMI)) at the time of hospital admission. The composite outcomes of first occurrence of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke (3-P-MACE), and all-cause mortality were assessed with a median follow-up of 338 days.
PYY levels were significantly associated with age and cardiovascular risk factors, including hypertension, diabetes, and kidney function in addition to biomarkers of heart failure (NT-pro BNP) and inflammation (hs-CRP). Further, PYY was significantly associated with 3-P-MACE (HR: 1.7; 95% CI: 1-2.97; = 0.0495) and all-cause mortality (HR: 2.69; 95% CI: 1.61-4.47; = 0.0001) by univariable Cox regression analyses, which was however lost after adjusting for multiple confounders.
PYY levels are associated with parameters of cardiovascular risk as well as cardiovascular events and mortality in patients presenting with acute myocardial infarction. However, this significant association is lost after adjustment for further confounders.
近期研究发现，胃肠道激素胰高血糖素样肽-1（GLP-1）的循环浓度是心肌梗死患者心血管风险的极佳预测指标。这表明胃肠道和心血管系统之间存在尚未被认识的相互作用，需要进一步研究。肠道来源的激素肽YY（PYY）与GLP-1由相同的肠道L细胞分泌。PYY在心血管疾病背景下的相关性尚未得到探索。在本研究中，我们旨在调查急性心肌梗死患者的PYY血清浓度，并评估其与心血管事件的关联。
对834例因急性心肌梗死入院的患者（553例非ST段抬高型心肌梗死（NSTEMI）和281例ST段抬高型心肌梗死（STEMI））进行PYY水平评估。评估首次发生心血管死亡、非致命性心肌梗死、非致命性卒中（3-P-MACE）和全因死亡率的复合结局，中位随访时间为338天。
PYY水平与年龄和心血管危险因素显著相关，除心力衰竭生物标志物（NT-pro BNP）和炎症生物标志物（hs-CRP）外，还包括高血压、糖尿病和肾功能。此外，通过单变量Cox回归分析，PYY与3-P-MACE（风险比：1.7；95%置信区间：1 - 2.97；P = 0.0495）和全因死亡率（风险比：2.69；95%置信区间：1.61 - 4.47；P = 0.0001）显著相关，但在调整多个混杂因素后这种相关性消失。
急性心肌梗死患者的PYY水平与心血管风险参数以及心血管事件和死亡率相关。然而，在调整进一步的混杂因素后，这种显著关联消失。
