Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
Dis Markers. 2022 Apr 27;2022:6119601. doi: 10.1155/2022/6119601. eCollection 2022.
Cold-inducible RNA-binding protein (CIRP) is a proinflammatory cytokine. The Global Registry of Acute Coronary Events (GRACE) risk score has been widely applied in risk stratification in patients with acute coronary syndrome (ACS). We aimed to investigate the prognostic value of CIRP in ACS patients and its incremental prognostic performance on top of GARCE score.
We consecutively enrolled 320 ACS patients, including 128 patients with ST-elevation myocardial infarction (STEMI), 67 patients with non-ST-elevation myocardial infarction (NSTEMI), and 125 patients with unstable angina pectoris (UAP). Plasma CIRP levels were measured at baseline. All patients received one-year follow-up for occurrence of major adverse cardiovascular outcomes (MACEs).
STEMI patients had a significantly higher concentration of plasma CIRP than those with NSTEMI ( = 0.001) and UAP ( < 0.001). Plasma CIRP level was positively correlated with GRACE score ( = 0.40, < 0.01). Survival analysis revealed that the risk of MACEs increased with increasing CIRP level (log-rank < 0.001). During follow-up, 45 (14.1%) patients experienced MACEs. Both GRACE score (hazard ratio: 1.023, 95% confidence interval: 1.007-1.050, = 0.021) and plasma CIRP level (hazard ratio:1.800, 95% confidence interval:1.209-2.679, = 0.004) were independently predictive of MACEs after Cox multivariate adjustment. Incremental predictive value was observed after combining CIRP with GRACE score.
Plasma CIRP was an independent prognostic biomarker and could improve the predictive value of GRACE score for prognosis in ACS patients.
冷诱导 RNA 结合蛋白（CIRP）是一种促炎细胞因子。全球急性冠状动脉事件注册（GRACE）风险评分已广泛应用于急性冠状动脉综合征（ACS）患者的风险分层。我们旨在探讨 CIRP 在 ACS 患者中的预后价值及其在 GRACE 评分之上的增量预后性能。
我们连续纳入了 320 例 ACS 患者，包括 128 例 ST 段抬高型心肌梗死（STEMI）患者、67 例非 ST 段抬高型心肌梗死（NSTEMI）患者和 125 例不稳定型心绞痛（UAP）患者。在基线时测量了血浆 CIRP 水平。所有患者均接受了为期 1 年的随访，以观察主要不良心血管事件（MACEs）的发生情况。
STEMI 患者的血浆 CIRP 浓度明显高于 NSTEMI（ = 0.001）和 UAP（ < 0.001）患者。血浆 CIRP 水平与 GRACE 评分呈正相关（ = 0.40， < 0.01）。生存分析显示，随着 CIRP 水平的升高，MACEs 的风险增加（对数秩检验 < 0.001）。在随访期间，有 45 例（14.1%）患者发生了 MACEs。GRACE 评分（风险比：1.023，95%置信区间：1.007-1.050， = 0.021）和血浆 CIRP 水平（风险比：1.800，95%置信区间：1.209-2.679， = 0.004）在 Cox 多变量调整后均为 MACEs 的独立预测因素。在将 CIRP 与 GRACE 评分相结合后，观察到了增量预测价值。
血浆 CIRP 是一种独立的预后生物标志物，可提高 GRACE 评分对 ACS 患者预后的预测价值。
