Department of Clinical Science, University of Bergen, Bergen, Norway.
Department of Cardiology, Stavanger University Hospital, P.O. Box 8100, 4068, Stavanger, Norway.
BMC Cardiovasc Disord. 2021 Oct 14;21(1):496. doi: 10.1186/s12872-021-02306-w.
Complement activation has been associated with atherosclerosis, atherosclerotic plaque destabilization and increased risk of cardiovascular events. Complement component 7 (CC7) binds to the C5bC6 complex which is part of the terminal complement complex (TCC/C5b-9). High-sensitivity C-reactive protein (hsCRP) is a sensitive marker of systemic inflammation and may reflect the increased inflammatory state associated with cardiovascular disease.
To evaluate the associations between CC7 and total- and cardiac mortality in patients hospitalized with chest-pain of suspected coronary origin, and whether combining CC7 with hsCRP adds prognostic information.
Baseline levels of CC7 were related to 60-months survival in a prospective, observational study of 982 patients hospitalized with a suspected acute coronary syndrome (ACS) at 9 hospitals in Salta, Argentina. A cox regression model, adjusting for conventional cardiovascular risk factors, was fitted with all-cause mortality, cardiac death and sudden cardiac death (SCD) as the dependent variables. A similar Norwegian population of 871 patients was applied to test the reproducibility of results in relation to total death.
At follow-up, 173 patients (17.7%) in the Argentinean cohort had died, of these 92 (9.4%) were classified as cardiac death and 59 (6.0%) as SCD. In the Norwegian population, a total of 254 patients (30%) died. In multivariable analysis, CC7 was significantly associated with 60-months all-cause mortality [hazard ratio (HR) 1.26 (95% confidence interval (CI), 1.07-1.47) and cardiac death [HR 1.28 (95% CI 1.02-1.60)], but not with SCD. CC7 was only weakly correlated with hsCRP (r = 0.10, p = 0.002), and there was no statistically significant interaction between the two biomarkers in relation to outcome. The significant association of CC7 with total death was reproduced in the Norwegian population.
CC7 was significantly associated with all-cause mortality and cardiac death at 60-months follow-up in chest-pain patients with suspected ACS.
ClinicalTrials.gov Identifier: NCT01377402, NCT00521976.
补体激活与动脉粥样硬化、动脉粥样硬化斑块不稳定和心血管事件风险增加有关。补体成分 7（CC7）与 C5bC6 复合物结合，该复合物是末端补体复合物（TCC/C5b-9）的一部分。高敏 C 反应蛋白（hsCRP）是全身炎症的敏感标志物，可能反映与心血管疾病相关的炎症状态增加。
评估补体 7（CC7）与因疑似冠心病胸痛住院的患者的全因和心脏死亡率之间的关系，以及将 CC7 与 hsCRP 结合是否增加预后信息。
在阿根廷萨尔塔的 9 家医院进行的一项前瞻性观察性研究中，对疑似急性冠状动脉综合征（ACS）住院的 982 例患者的基线 CC7 水平与 60 个月的生存情况进行了相关分析。使用 Cox 回归模型，以全因死亡率、心脏死亡和心源性猝死（SCD）作为因变量，对常规心血管危险因素进行了调整。在挪威的一个类似人群中，应用了 871 例患者的结果，以验证全因死亡的结果的可重复性。
在随访中，阿根廷队列中有 173 例（17.7%）患者死亡，其中 92 例（9.4%）被归类为心脏死亡，59 例（6.0%）为 SCD。在挪威人群中，共有 254 例（30%）患者死亡。多变量分析显示，CC7 与 60 个月全因死亡率显著相关[风险比（HR）1.26（95%置信区间（CI），1.07-1.47）和心脏死亡（HR 1.28（95%CI 1.02-1.60）]，但与 SCD 无关。CC7 与 hsCRP 仅有微弱相关性（r=0.10，p=0.002），并且在这两种生物标志物与结局之间不存在统计学显著的相互作用。在挪威人群中，CC7 与全因死亡的显著相关性得到了重现。
在疑似 ACS 的胸痛患者中，CC7 与 60 个月时的全因死亡率和心脏死亡率显著相关。
ClinicalTrials.gov 标识符：NCT01377402，NCT00521976。
