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足突蛋白与疑似急性冠脉综合征入院患者的不良临床结局

Podocan and Adverse Clinical Outcome in Patients Admitted With Suspected Acute Coronary Syndromes.

作者信息

Andersen Thomas, Ueland Thor, Aukrust Pål, Nilsen Dennis W, Grundt Heidi, Staines Harry, Kontny Frederic

机构信息

Department of Anesthesiology, Stavanger University Hospital, Stavanger, Norway.

Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.

出版信息

Front Cardiovasc Med. 2022 May 20;9:867944. doi: 10.3389/fcvm.2022.867944. eCollection 2022.

Abstract

BACKGROUND

Markers of bone and extracellular matrix (ECM) remodeling may be associated with adverse outcomes in atherosclerotic cardiovascular disease. Podocan is a newly discovered ECM glycoprotein, previously not studied in a chest pain population. We wanted to study the association between Podocan levels on admission and the risk of adverse outcomes in a chest pain population with suspected acute coronary syndromes.

METHODS

A total of 815 patients from the Risk markers in Acute Coronary Syndrome (RACS) trial with suspected coronary chest pain were followed for 7 years. Blood samples were taken immediately after inclusion and stored in the biobank. Associations between Podocan and endpoints were assessed with Cox proportional hazards analyses.

RESULTS

The median admission level of Podocan was 0.674 ng/ml (0.566-0.908 ng/ml). No significant association was found between Podocan quartile levels and all-cause death, neither at 1 year nor 2- or 7-years follow-up ( > 0.05 for all). Furthermore, no significant association could be shown between Podocan and cardiac death, myocardial infarction (MI), stroke, or the composites of all-cause death/MI/stroke or cardiac death/MI/stroke ( > 0.05 for all). Similarly, in a subgroup of patients with Troponin T-positive ( = 432) there was no significant association between Podocan and any of the outcome measures ( > 0.05 for all endpoints and points in time).

CONCLUSION

Podocan, a novel ECM biomarker, is not associated with all-cause mortality or other major cardiovascular adverse events in patients admitted with acute chest pain suspected to be of coronary origin.

CLINICAL TRIALSGOV IDENTIFIER

NCT00521976.

摘要

背景

骨和细胞外基质(ECM)重塑标志物可能与动脉粥样硬化性心血管疾病的不良结局相关。Podocan是一种新发现的ECM糖蛋白,此前未在胸痛人群中进行研究。我们旨在研究胸痛疑似急性冠状动脉综合征人群入院时Podocan水平与不良结局风险之间的关联。

方法

对急性冠状动脉综合征风险标志物(RACS)试验中815例疑似冠状动脉胸痛患者进行了7年随访。纳入后立即采集血样并储存于生物样本库。采用Cox比例风险分析评估Podocan与终点事件之间的关联。

结果

Podocan的入院中位水平为0.674 ng/ml(0.566 - 0.908 ng/ml)。在1年、2年或7年随访中,均未发现Podocan四分位数水平与全因死亡之间存在显著关联(所有P>0.05)。此外,Podocan与心源性死亡、心肌梗死(MI)、中风或全因死亡/MI/中风或心源性死亡/MI/中风的复合终点之间也未显示出显著关联(所有P>0.05)。同样,在肌钙蛋白T阳性患者亚组(n = 432)中,Podocan与任何结局指标之间均无显著关联(所有终点和时间点的P>0.05)。

结论

Podocan作为一种新型ECM生物标志物,与疑似冠状动脉起源的急性胸痛入院患者的全因死亡率或其他主要心血管不良事件无关。

临床试验注册号

NCT00521976。

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