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血管周围脂肪组织中抵抗素水平与冠状动脉旁路移植术后中期死亡率的关系。

Resistin levels in perivascular adipose tissue and mid-term mortality in patients undergoing coronary artery bypass grafting.

机构信息

Department of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland.

出版信息

Physiol Res. 2021 Aug 31;70(4):543-550. doi: 10.33549/physiolres.934661. Epub 2021 Jun 1.

Abstract

Higher serum resistin levels were reported to be associated with increased mortality risk. We aimed to assess the predictive value of resistin levels in perivascular adipose tissue (PVAT) around the left main coronary artery (LMCA) for mid-term survival of patients with advanced coronary artery disease (CAD).This was a prospective study including patients referred for elective coronary artery grafting in 2016 and 2017, performed using a standard approach. A sample of PVAT was harvested and resistin levels were measured using an enzyme-linked immunosorbent assay. Patients were followed from the day of the procedure until March 2021. In each patient, the SYNTAX score and EuroSCORE II were calculated. The study included 108 patients aged 68.1 ±7.9 years, including 83 men (76.9%). The duration of follow-up was 731 (range, 275-1020) for nonsurvivors and 1418 median (range, 1174-1559) for survivors (p <0.001). Patients who died had a higher SYNTAX score, higher EuroSCORE II, and lower resistin levels in PVAT than survivors (p <0.001, p = 0.004, and p = 0.041, respectively). A stepwise regression analysis revealed that survival was related to resistin concentrations above the median value (hazard ratio [HR], 4.67; 95% CI, 1.02-21.4; p = 0.048) and EuroSCORE II (used as continuous variable; HR, 1.55; 95% CI, 1.16-2.07; p = 0.003). The mid-term mortality in patients with advanced CAD is associated with low resistin concentrations in PVAT surrounding the LMCA.

摘要

已有研究报道,血清抵抗素水平升高与死亡率增加相关。本研究旨在评估左主干冠状动脉(LMCA)周围血管周围脂肪组织(PVAT)中的抵抗素水平对晚期冠状动脉疾病(CAD)患者中期生存的预测价值。

这是一项前瞻性研究,纳入了 2016 年和 2017 年择期行冠状动脉旁路移植术的患者,采用标准方法进行。采集 PVAT 样本,使用酶联免疫吸附试验测量抵抗素水平。患者从手术当天开始随访至 2021 年 3 月。在每位患者中,计算 SYNTAX 评分和 EuroSCORE II。

本研究共纳入 108 例年龄 68.1±7.9 岁的患者,其中 83 例男性(76.9%)。非幸存者的随访时间为 731(范围 275-1020)天,幸存者为 1418 天(中位数,范围 1174-1559)天(p<0.001)。与幸存者相比,死亡患者的 SYNTAX 评分更高,EuroSCORE II 更高,PVAT 中的抵抗素水平更低(p<0.001,p=0.004 和 p=0.041)。逐步回归分析显示,生存与中位数以上的抵抗素浓度(危险比[HR],4.67;95%置信区间[CI],1.02-21.4;p=0.048)和 EuroSCORE II(作为连续变量;HR,1.55;95%CI,1.16-2.07;p=0.003)相关。

晚期 CAD 患者的中期死亡率与 LMCA 周围 PVAT 中的低抵抗素浓度相关。

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