Xie SiXin, Jiang HuiQiong, Gao ZiLin, Lin YongJun, Hong NaJiao
SiXin Xie, Department of Cardiac Function Examination, First Hospital of Quanzhou Affiliated to Fujian Medical University, City Fujian Province, 362001, China.
HuiQiong Jiang, Department of Cardiac Function Examination, First Hospital of Quanzhou Affiliated to Fujian Medical University, City Fujian Province, 362001, China.
Pak J Med Sci. 2023 Jul-Aug;39(4):972-977. doi: 10.12669/pjms.39.4.7324.
To investigate the clinical effects of NRLP1 expression in patients with ST-segment elevation myocardial infarction (STEMI) combined with arrhythmia.
We enrolled 231 patients with STEMI in the first hospital of Quanzhou affiliated to Fujian Medical University from January 2019 to December 2020 to the observational group and 230 healthy individuals as the control group. We divided patients with STEMI into a malignant ventricular arrhythmia (MVA) group (=36) and non-MVA(NMVA) group (=195) depending on whether the individuals had experienced an episode of MVA within 48 hours after PCI. We recorded general variables such as age, gender, history of smoking, hypertension, of diabetes, hyperlipidemia, left ventricular ejection fraction (LVEF), Gensini score, and mortality. Moreover, we determined NLRP1, IL-1β, TNF-α, high-sensitivity C-reactive protein (hs-CRP), N-terminal pro-brain natriuretic peptide (NT-pro-BNP), cardiac troponin-1 (cTnI), and creatine kinase isoenzyme (CK-MB) in peripheral blood by ELISA.
We found significant differences in LVEF, Gensini scores, smoking history, and mortality between the MVA and NMVA groups. The mean NLRP1 expression was highest in the MVA group, which was positively correlated with the levels of IL-1β, TNF-α, hs-CRP, NT-pro-BNP, cTnI and CK-MB. The expression of NLRP1 was associated with the smoking history, the LVEF value, the Gensini score, the MVA incidence and the mortality. Patients with higher NLRP1 expression levels had a higher MACE incidence and worse overall survivals within one year.
The NLRP1 pathway is associated with the presence of arrhythmias after PCI treatments, and the NLRP1 expression level may be useful as a predictor of arrhythmia in patients with STEMI.
探讨NLRP1表达在ST段抬高型心肌梗死(STEMI)合并心律失常患者中的临床作用。
选取2019年1月至2020年12月在福建医科大学附属泉州第一医院就诊的231例STEMI患者作为观察组,选取230例健康个体作为对照组。根据患者在PCI术后48小时内是否发生恶性室性心律失常(MVA),将STEMI患者分为MVA组(n = 36)和非MVA(NMVA)组(n = 195)。记录年龄、性别、吸烟史、高血压、糖尿病、高脂血症、左心室射血分数(LVEF)、Gensini评分和死亡率等一般变量。此外,采用ELISA法检测外周血中NLRP1、IL-1β、TNF-α、高敏C反应蛋白(hs-CRP)、N末端脑钠肽前体(NT-pro-BNP)、心肌肌钙蛋白I(cTnI)和肌酸激酶同工酶(CK-MB)。
我们发现MVA组和NMVA组在LVEF、Gensini评分、吸烟史和死亡率方面存在显著差异。MVA组的平均NLRP1表达最高,且与IL-1β、TNF-α、hs-CRP、NT-pro-BNP、cTnI和CK-MB水平呈正相关。NLRP1的表达与吸烟史、LVEF值、Gensini评分、MVA发生率和死亡率相关。NLRP1表达水平较高的患者MACE发生率较高,且1年内总体生存率较差。
NLRP1通路与PCI治疗后心律失常的发生有关,NLRP1表达水平可能作为STEMI患者心律失常的预测指标。