Xu Wei-Xian, Fan Yuan-Yuan, Song Yao, Liu Xin, Liu Hui, Guo Li-Jun
Department of Cardiology, Peking University Third Hospital, Beijing 100191, China.
World J Emerg Med. 2022;13(3):169-174. doi: 10.5847/wjem.j.1920-8642.2022.055.
Previous studies have reported inconsistent findings regarding the association between catestatin and outcomes of acute myocardial infarction (AMI). This study aims to investigate the prognostic value of catestatin for long-term outcomes in patients with AMI.
One hundred and sixty-five patients with AMI were enrolled in this series. The plasma catestatin levels at baseline and clinical data were collected. All patients were followed up for four years to investigate whether there were major adverse cardiovascular events (MACEs), including cardiovascular death, recurrent AMI, rehospitalization for heart failure, and revascularization.
There were 24 patients who had MACEs during the follow-up period. The MACEs group had significantly lower plasma catestatin levels (0.74±0.49 ng/mL vs. 1.10±0.79 ng/mL, =0.033) and were older (59.0±11.4 years old vs. 53.2±12.8 years old, =0.036). The rate of MACEs was significantly higher in the elderly group (≥60 years old) than in the young group (<60 years old) (23.8% [15/63] vs. 8.8% [9/102], =0.008). The catestatin level was significantly lower in the MACEs group than that in the non-MACEs group (0.76±0.50 ng/mL vs. 1.31±0.77 ng/mL, =0.012), and catestatin was significantly associated with MACEs (Kaplan Meier, =0.007) among the elderly group, but not in the young group (Kaplan Meier, =0.893). In the Cox proportional hazards regression, high catestatin was one of the independent factors for predicting MACEs after adjustment for other risk factors (hazard ratio 0.19, 95% confidence interval 0.06-0.62, =0.006) among elderly patients.
Elderly AMI patients with lower plasma catestatin levels are more likely to develop MACEs. Catestatin may be a novel marker for the long-term prognosis of AMI, especially in elderly patients.
既往研究报道了关于抑癌素与急性心肌梗死(AMI)预后之间关联的不一致结果。本研究旨在探讨抑癌素对AMI患者长期预后的预测价值。
本研究纳入了165例AMI患者。收集患者基线时的血浆抑癌素水平及临床资料。所有患者随访4年,以调查是否发生主要不良心血管事件(MACE),包括心血管死亡、再发AMI、因心力衰竭再次住院以及血管重建。
随访期间有24例患者发生MACE。发生MACE的患者血浆抑癌素水平显著更低(0.74±0.49 ng/mL对1.10±0.79 ng/mL,P = 0.033)且年龄更大(59.0±11.4岁对53.2±12.8岁,P = 0.036)。老年组(≥60岁)的MACE发生率显著高于年轻组(<60岁)(23.8% [15/63]对8.8% [9/102],P = 0.008)。发生MACE的患者抑癌素水平显著低于未发生MACE的患者(0.76±0.50 ng/mL对1.31±0.77 ng/mL,P = 0.012),且在老年组中抑癌素与MACE显著相关(Kaplan - Meier法,P = 0.007),但在年轻组中不相关(Kaplan - Meier法,P = 0.893)。在Cox比例风险回归分析中,在调整其他危险因素后,高抑癌素水平是老年患者预测MACE的独立因素之一(风险比0.19,95%置信区间0.06 - 0.62,P = 0.006)。
血浆抑癌素水平较低的老年AMI患者更易发生MACE。抑癌素可能是AMI长期预后的一个新标志物,尤其是在老年患者中。