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β2-肾上腺素能受体自身抗体与首发 ST 段抬高型心肌梗死患者左前降支近段病变的关系。

Association among β2-adrenergic receptor autoantibodies and proximal left anterior descending artery lesions in patients with initial ST-segment elevation myocardial infarction.

机构信息

Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

Beijing Key Laboratory of Metabolic Disorder Related Cardiovascular Disease, Beijing, China.

出版信息

Clin Cardiol. 2023 Nov;46(11):1371-1379. doi: 10.1002/clc.24129. Epub 2023 Aug 17.

Abstract

BACKGROUND

β -adrenergic receptor autoantibody (β -AA) are widely present in patients with many different types of cardiovascular diseases. Proximal left anterior descending (LAD) artery lesions are associated with adverse prognostic events in patients with ST-segment elevation myocardial infarction (STEMI).

HYPOTHESIS

β -AA is associated with the presence of proximal LAD lesions in patients with STEMI.

METHODS

A cohort of 153 patients with STEMI who underwent primary percutaneous coronary intervention (PPCI) was enrolled in the study. Baseline characteristics were compared between the proximal LAD group (n = 62) and the nonproximal LAD group (n = 91). Admission serum of patients was collected to detect the level of β -AA. Data for echocardiogram within 24 hours after PPCI and at the 6-month follow-up were recorded.

RESULTS

The optical density values and positive rates of β -AA in the proximal LAD group were higher than those in the nonproximal LAD group (p < 0.05). β -AA positively correlated with high sensitivity C-reactive protein and peak N-terminal pro-B type natriuretic peptide levels in the proximal LAD group, but those were not relevant in the nonproximal LAD group. Multivariate logistic regression analysis revealed that high β -AA levels was independently associated with the presence of proximal LAD lesions in patients with STEMI. Furthermore, a receiver operating characteristic curve was used to show the efficiency of β -AA levels to detect proximal LAD lesions, and the AUC of the β2-AA OD value was 0.658 (95% confidence interval 0.568-0.749; p = 0.001).

CONCLUSIONS

The STEMI patients with high β -AA levels had a greater possibility having proximal LAD lesions.

摘要

背景

β-肾上腺素能受体自身抗体(β-AA)广泛存在于多种心血管疾病患者中。ST 段抬高型心肌梗死(STEMI)患者的左前降支(LAD)近段病变与不良预后事件相关。

假说

β-AA 与 STEMI 患者 LAD 近段病变的存在相关。

方法

本研究纳入了 153 例接受直接经皮冠状动脉介入治疗(PPCI)的 STEMI 患者。比较 LAD 近段组(n=62)和非 LAD 近段组(n=91)患者的基线特征。采集患者入院时的血清以检测β-AA 水平。记录 PPCI 后 24 小时内及 6 个月随访时的超声心动图数据。

结果

LAD 近段组的β-AA 光密度值和阳性率均高于非 LAD 近段组(p<0.05)。β-AA 与 LAD 近段组的高敏 C 反应蛋白和 N 末端脑钠肽前体峰值水平呈正相关,但与非 LAD 近段组无关。多变量 logistic 回归分析显示,β-AA 水平升高与 STEMI 患者 LAD 近段病变的存在独立相关。此外,绘制受试者工作特征曲线显示β-AA 水平检测 LAD 近段病变的效率,β2-AA OD 值的 AUC 为 0.658(95%置信区间 0.568-0.749;p=0.001)。

结论

β-AA 水平较高的 STEMI 患者发生 LAD 近段病变的可能性更大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfaa/10642316/09e5fef7f967/CLC-46-1371-g002.jpg

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