Blanco-Colio Luis M, Méndez-Barbero Nerea, Pello Lázaro Ana María, Aceña Álvaro, Tarín Nieves, Cristóbal Carmen, Martínez-Milla Juan, González-Lorenzo Óscar, Martín-Ventura José Luis, Huelmos Ana, Gutiérrez-Landaluce Carlos, López-Castillo Marta, Kallmeyer Andrea, Cánovas Ester, Alonso Joaquín, López Bescós Lorenzo, Egido Jesús, Lorenzo Óscar, Tuñón José
Vascular Research Lab, IIS-Fundación Jiménez Díaz, 28040 Madrid, Spain.
Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, 28029 Madrid, Spain.
J Clin Med. 2021 Mar 9;10(5):1137. doi: 10.3390/jcm10051137.
Clinical data indicate that patients with C-reactive protein (CRP) levels higher than 2 mg per liter suffer from persistent inflammation, which is associated with high risk of cardiovascular disease (CVD). We determined whether a panel of biomarkers associated with CVD could predict recurrent events in patients with low or persistent inflammation and coronary artery disease (CAD). We followed 917 patients with CAD (median 4.59 ± 2.39 years), assessing CRP, galectin-3, monocyte chemoattractant protein-1 (MCP-1), N-terminal fragment of brain natriuretic peptide (NT-proBNP) and troponin-I plasma levels. The primary outcome was the combination of cardiovascular events (acute coronary syndrome, stroke or transient ischemic event, heart failure or death). Patients with persistent inflammation ( = 343) showed higher NT-proBNP and MCP-1 plasma levels compared to patients with CRP < 2 mg/L. Neither MCP-1 nor NT-proBNP was associated with primary outcome in patients with CRP < 2 mg/L. However, NT-proBNP and MCP-1 plasma levels were associated with increased risk of the primary outcome in patients with persistent inflammation. When patients were divided by type of event, MCP-1 was associated with an increased risk of acute ischemic events. A significant interaction between MCP-1 and persistent inflammation was found (synergy index: 6.17 (4.39-7.95)). In conclusion, MCP-1 plasma concentration is associated with recurrent cardiovascular events in patients with persistent inflammation.
临床数据表明，C反应蛋白（CRP）水平高于每升2毫克的患者存在持续性炎症，这与心血管疾病（CVD）的高风险相关。我们确定了一组与CVD相关的生物标志物是否能够预测低炎症或持续性炎症及冠心病（CAD）患者的复发事件。我们对917例CAD患者进行了随访（中位时间为4.59±2.39年），评估了CRP、半乳糖凝集素-3、单核细胞趋化蛋白-1（MCP-1）、脑钠肽N端片段（NT-proBNP）和肌钙蛋白I的血浆水平。主要结局是心血管事件（急性冠状动脉综合征、中风或短暂性缺血事件、心力衰竭或死亡）的综合情况。与CRP<2毫克/升的患者相比，持续性炎症患者（n = 343）的NT-proBNP和MCP-1血浆水平更高。在CRP<2毫克/升的患者中，MCP-1和NT-proBNP均与主要结局无关。然而，在持续性炎症患者中，NT-proBNP和MCP-1血浆水平与主要结局风险增加相关。当根据事件类型对患者进行分组时，MCP-1与急性缺血事件风险增加相关。发现MCP-1与持续性炎症之间存在显著交互作用（协同指数：6.17（4.39 - 7.95））。总之，MCP-1血浆浓度与持续性炎症患者的心血管复发事件相关。
