Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Beijing Key Laboratory of Metabolic Disorder Related Cardiovascular Disease, Beijing, China.
Clin Cardiol. 2023 Nov;46(11):1371-1379. doi: 10.1002/clc.24129. Epub 2023 Aug 17.
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).
β -AA is associated with the presence of proximal LAD lesions in patients with STEMI.
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.
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).
The STEMI patients with high β -AA levels had a greater possibility having proximal LAD lesions.
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。
β-AA 与 STEMI 患者 LAD 近段病变的存在相关。
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。
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)。
β-AA 水平较高的 STEMI 患者发生 LAD 近段病变的可能性更大。