Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan.
School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
BMC Cardiovasc Disord. 2023 Nov 16;23(1):564. doi: 10.1186/s12872-023-03565-5.
Renal function decline is a frequently encountered complication in patients with chronic coronary syndrome. Aside from traditional cardiovascular risk factors, the inflammatory burden emerged as the novel phenotype that compromised renal prognosis in such population.
A cohort with chronic coronary syndrome was enrolled to investigate the association between inflammatory status and renal dysfunction. Levels of inflammatory markers, including high-sensitivity C-reactive protein (hs-CRP), tumour necrosis factor-α (TNF-α), adiponectin, matrix metalloproteinase-9, interleukin-6, lipoprotein-associated phospholipase A2, were assessed. Renal event was defined as > 25% decline in estimated glomerular filtration rate (eGFR). Inflammatory scores were calculated based on the aggregate of hs-CRP, TNF-α, and adiponectin levels.
Among the 850 enrolled subjects, 145 patients sustained a renal event during an averaged 3.5 years follow-up. Multivariate analysis with Cox regression suggested elevations in hs-CRP, TNF-α, and adiponectin levels were independent risk factors for the occurrence of a renal event. Whereas, Kaplan-Meier curve illustrated significant correlation between high TNF-α (P = 0.005), adiponectin (P < 0.001), but not hs-CRP (P = 0.092), and eGFR decline. The aggregative effect of these biomarkers was also distinctly correlated with renal events (score 2: P = 0.042; score 3: P < 0.001).
Inflammatory burden was associated with eGFR decline in patients with chronic coronary syndrome.
肾功能下降是慢性冠状动脉综合征患者经常遇到的并发症。除了传统的心血管危险因素外，炎症负担已成为影响此类人群肾功能预后的新型表型。
本研究纳入了慢性冠状动脉综合征患者队列，旨在探讨炎症状态与肾功能障碍之间的关系。评估了炎症标志物水平，包括高敏 C 反应蛋白（hs-CRP）、肿瘤坏死因子-α（TNF-α）、脂联素、基质金属蛋白酶-9、白细胞介素-6、脂蛋白相关磷脂酶 A2。肾脏事件定义为估算肾小球滤过率（eGFR）下降>25%。根据 hs-CRP、TNF-α 和脂联素水平的总和计算炎症评分。
在 850 名纳入的受试者中，145 名患者在平均 3.5 年的随访中发生了肾脏事件。Cox 回归多变量分析表明，hs-CRP、TNF-α 和脂联素水平升高是肾脏事件发生的独立危险因素。然而，Kaplan-Meier 曲线表明，TNF-α（P=0.005）、脂联素（P<0.001）水平与 eGFR 下降显著相关，但 hs-CRP 水平与 eGFR 下降无显著相关性（P=0.092）。这些生物标志物的综合效应与肾脏事件也明显相关（评分 2：P=0.042；评分 3：P<0.001）。
炎症负担与慢性冠状动脉综合征患者的 eGFR 下降相关。
