Murad Hussam A S, Bakarman Marwan A
Department of Pharmacology, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia.
Department of Family and Community Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia.
Int J Angiol. 2022 Sep 23;32(3):165-171. doi: 10.1055/s-0042-1756488. eCollection 2023 Sep.
Plasma level of chemokine CXCL12 can predict adverse cardiovascular outcomes in patients with coronary artery disease, but data on its relationship with severity of coronary stenosis in cases of severe myocardial infarction (MI) are scarce and conflicting. The objective of this study was to investigate link between plasma CXCL12 levels and different grades of left ventricular ejection fraction (LVEF) in statin-treated and -untreated patients with severe MI. A total of 198 consecutive patients with first-time severe MI (ST-elevated myocardial infarction [STEMI], = 121 and non-ST-elevated myocardial infarction [NSTEMI], = 77) were recruited from Coronary Care Unit, King Abdulaziz University Hospital. They have one to two coronary arteries blocked ≥50%, or three arteries blocked 30 to 49%. Demographic and clinical criteria were collected and plasma CXCL12 level was measured. No correlations were detected between demographic and clinical criteria and CXCL12 level. While troponin peaks and LVEF significantly differed between STEMI and NSTEMI patients, CXCL12 level showed nonsignificant changes. Plasma CXCL12 levels decreased significantly in statin-treated patients compared with those untreated. From receiver operating characteristic (ROC) analysis, high CXCL12 levels were associated with no statin therapy. For STEMI and NSTEMI patients, area under the receiver operating characteristic curve for CXCL12 test were 0.685 and 0.820, while sensitivity and specificity values were 75.9 and 54.8%, and 73.1 and 84%, respectively. Plasma CXCL12 levels showed nonsignificant changes with different ranges of LVEF and troponin peaks. In patients with severe MI, irrespective of statin therapy, plasma CXCL12 showed no correlation with different ranges of LVEF suggesting that it cannot predict left ventricular dysfunction in these cases. However, cross-sectional design of this study is a limitation.
趋化因子CXCL12的血浆水平可预测冠心病患者的不良心血管结局，但关于其在严重心肌梗死（MI）病例中与冠状动脉狭窄严重程度关系的数据却很稀少且相互矛盾。本研究的目的是调查在接受他汀类药物治疗和未接受治疗的严重MI患者中，血浆CXCL12水平与不同等级左心室射血分数（LVEF）之间的联系。从阿卜杜勒阿齐兹国王大学医院冠心病监护病房连续招募了198例首次发生严重MI的患者（ST段抬高型心肌梗死[STEMI]，n = 121；非ST段抬高型心肌梗死[NSTEMI]，n = 77）。他们有一到两支冠状动脉阻塞≥50%，或三支冠状动脉阻塞30%至49%。收集了人口统计学和临床标准，并测量了血浆CXCL12水平。未检测到人口统计学和临床标准与CXCL12水平之间的相关性。虽然STEMI和NSTEMI患者的肌钙蛋白峰值和LVEF有显著差异，但CXCL12水平变化不显著。与未接受治疗的患者相比，接受他汀类药物治疗的患者血浆CXCL12水平显著降低。根据受试者工作特征（ROC）分析，CXCL12水平高与未接受他汀类药物治疗有关。对于STEMI和NSTEMI患者，CXCL12检测的受试者工作特征曲线下面积分别为0.685和0.820，而敏感性和特异性值分别为75.9%和54.8%，以及73.1%和84%。血浆CXCL12水平在不同LVEF范围和肌钙蛋白峰值时变化不显著。在严重MI患者中，无论是否接受他汀类药物治疗，血浆CXCL12与不同LVEF范围均无相关性，这表明在这些病例中它无法预测左心室功能障碍。然而，本研究的横断面设计是一个局限性。
