Yu Xiao-Lin, Zhao Qian, Liu Fen, Yuan Yu-Juan, Fang Bin-Bin, Zhang Xue-He, Li Wen-Ling, Li Xiao-Mei, Du Guo-Li, Gao Xiao-Ming, Yang Yi-Ning
Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Ürümqi, China.
Xinjiang Key Laboratory of Cardiovascular Disease Research, Clinical Medical Research Institute of First Affiliated Hospital of Xinjiang Medical University, Ürümqi, China.
Front Cardiovasc Med. 2022 Aug 11;9:947395. doi: 10.3389/fcvm.2022.947395. eCollection 2022.
Metabolic syndrome (MetS) is a major risk factor for cardiovascular disease and negatively affecting the prognosis of patients with ST elevation myocardial infarction (STEMI). Macrophage migration inhibitory factor (MIF) is a multipotent cytokine involved in various cardiovascular and inflammatory diseases. In this prospective study, we investigate the value of MIF in the long-term prognosis of STEMI combined with MetS after emergency PCI. Circulating MIF levels were measured at admission, and major adverse cardiovascular and cerebrovascular events (MACCE) were monitored during the follow-up period of 4.9 (3.9-5.8) years. MACCE occurred in 92 patients (22.9%), which was significantly higher in MetS (69/255, 27.1%) than in the non-MS subgroup (23/146, 15.8%, < 0.05). Patients with MetS developed MACCE had the highest admission MIF level. Kaplan-Meier survival analysis using the cutoff value of admission MIF (143 ng/ml) showed that patients with a higher MIF level had a greater incidence of MACCE than those with lower MIF levels in both the MetS ( < 0.0001) and non-MetS groups ( = 0.016). After adjustment for clinical variables, the value of MIF ≥ 143 ng/ml still had the predictive power for the MetS group [HR 9.56, 95% CI (5.397-16.944), < 0.001]; nevertheless, it was not the case in the non-MetS group. Our findings indicated that MetS is a critical risk factor for adverse clinical outcomes in patients with STEMI, and a high admission MIF level has predictive power for the long-term MACCE, which is superior in STEMI patients with MetS and better than other traditional predictors.
代谢综合征（MetS）是心血管疾病的主要危险因素，对ST段抬高型心肌梗死（STEMI）患者的预后产生负面影响。巨噬细胞移动抑制因子（MIF）是一种多效细胞因子，参与多种心血管和炎症性疾病。在这项前瞻性研究中，我们探讨了MIF在急诊经皮冠状动脉介入治疗（PCI）后STEMI合并MetS患者长期预后中的价值。入院时测定循环MIF水平，并在4.9（3.9 - 5.8）年的随访期内监测主要不良心血管和脑血管事件（MACCE）。92例患者（22.9%）发生MACCE，其中MetS组（69/255，27.1%）显著高于非MetS亚组（23/146，15.8%，P < 0.05）。发生MACCE的MetS患者入院时MIF水平最高。采用入院时MIF的临界值（143 ng/ml）进行Kaplan-Meier生存分析显示，在MetS组（P < 0.0001）和非MetS组（P = 0.016）中，MIF水平较高的患者MACCE发生率均高于MIF水平较低的患者。在调整临床变量后，MIF≥143 ng/ml的值在MetS组中仍具有预测能力[风险比（HR）9.56，95%置信区间（CI）（5.397 - 16.944），P < 0.001]；然而，在非MetS组中并非如此。我们的研究结果表明，MetS是STEMI患者不良临床结局的关键危险因素，入院时高MIF水平对长期MACCE具有预测能力，在STEMI合并MetS的患者中表现更优，且优于其他传统预测指标。
