Güner Ahmet, Zehİr Regayİp, KalçIk Macİt, Uslu Abdulkadİr, Ösken Altuğ, Kalkan Alİ Kemal, Güner Ezgİ Gültekİn
Department of Cardiology, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey.
Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
Interv Med Appl Sci. 2019 Oct 7;11(3):146-153. doi: 10.1556/1646.11.2019.17. eCollection 2020 Sep.
In addition to proinflammatory properties, eosinophils can stimulate platelet activation and enhance prothrombotic pathways. In this study, we aimed to investigate the association between the eosinophil percentage (EOS%) and major adverse cardiac events (MACE) in patients with ST-segment elevation myocardial infarction (STEMI).
This study enrolled a total of 1,909 patients who were diagnosed with STEMI. Ventricular arrhythmia, reinfarction, the need for cardiopulmonary resuscitation, target vessel revascularization, congestive heart failure, and cardiovascular mortality during index hospitalization were defined as MACE.
Three hundred and eighty patients (19.7%) reached the combined endpoint with MACE. The rates of inhospital mortality and MACE were significantly higher in low EOS% group as compared to high EOS% group (4% vs. 1.1%, < 0.01 and 32.8% vs. 11.3%, < 0.01, respectively). On multivariate logistic regression analyses, EOS% (OR = 0.44, < 0.01) was found to be one of the independent predictors of MACE. The EOS% lower than 0.60 on admission predicted inhospital MACE with a sensitivity of 68% and a specificity of 72% (AUC: 0.684, < 0.01).
Low EOS% on admission may be associated with high inhospital MACE in STEMI patients. EOS% may be used as a novel biomarker for risk stratification of these patients.
除了具有促炎特性外,嗜酸性粒细胞还可刺激血小板活化并增强血栓形成前通路。在本研究中,我们旨在探讨ST段抬高型心肌梗死(STEMI)患者中嗜酸性粒细胞百分比(EOS%)与主要不良心脏事件(MACE)之间的关联。
本研究共纳入1909例诊断为STEMI的患者。将心室心律失常、再梗死、心肺复苏需求、靶血管血运重建、充血性心力衰竭以及住院期间的心血管死亡率定义为MACE。
380例患者(19.7%)达到了合并终点MACE。低EOS%组的住院死亡率和MACE发生率显著高于高EOS%组(分别为4%对1.1%,P<0.01;32.8%对11.3%,P<0.01)。多因素逻辑回归分析发现,EOS%(OR=0.44,P<0.01)是MACE的独立预测因素之一。入院时EOS%低于0.60预测住院MACE的敏感性为68%,特异性为72%(AUC:0.684,P<0.01)。
入院时低EOS%可能与STEMI患者住院期间高MACE相关。EOS%可作为这些患者风险分层的新型生物标志物。