Stavanger University Hospital, Department of Cardiology, Stavanger, Norway.
University of Bergen, Department of Clinical Science, Bergen, Norway.
Cardiology. 2024;149(4):338-346. doi: 10.1159/000537919. Epub 2024 Feb 25.
SERPINA3 is an acute-phase protein triggered by inflammation. It is upregulated after an acute myocardial infarction (AMI). Data on its long-term prognostic value in MI patients are scarce. We aimed to assess the utility of SERPINA3 as a prognostic marker in patients hospitalized for chest pain of suspected coronary origin.
A total of 871 consecutive patients, 386 diagnosed with AMI, were included. Stepwise Cox regression models, applying continuous loge-transformed values, were fitted for the biomarker with all-cause mortality and cardiac death within 2 years or all-cause mortality within the median 7 years as dependent variables. An analysis of MI and stroke, and combined endpoints, respectively, was added. The hazard ratio (HR) (95% CI) was assessed in a univariate and multivariable model.
Plasma samples from 847 patients were available. By 2-year follow-up, 138 (15.8%) patients had died, of which 86 were cardiac deaths. The univariate analysis showed a significant association between SERPINA3 and all-cause mortality (HR 1.41 [95% 1.19-1.68], p < 0.001) but not for cardiac death. Associations after adjustment were non-significant. By 7-year follow-up, 332 (38.1%) patients had died. SERPINA3 was independently associated with all-cause mortality from the third year onward. The HR was 1.14 (95% CI, 1.02-1.28), p = 0.022. Similar results applied to combined endpoints, but not for MI and stroke, respectively. The prognostic value of SERPINA3 was limited to non-AMI patients. No independent associations were noted among AMI patients.
SERPINA3 predicts long-term all-cause mortality but fails to predict outcome in AMI patients.
SERPINA3 是一种由炎症引发的急性期蛋白。它在急性心肌梗死（AMI）后上调。关于其在 MI 患者中的长期预后价值的数据很少。我们旨在评估 SERPINA3 作为怀疑冠心病胸痛住院患者预后标志物的效用。
共纳入 871 例连续患者，其中 386 例诊断为 AMI。应用逐步 Cox 回归模型，对所有原因死亡率和 2 年内心脏性死亡或中位 7 年内所有原因死亡率作为因变量的生物标志物进行连续对数转换值。分别添加 MI 和卒中分析以及联合终点分析。在单变量和多变量模型中评估危险比（HR）（95%CI）。
847 例患者的血浆样本可用。在 2 年随访时，138 例（15.8%）患者死亡，其中 86 例为心脏性死亡。单变量分析显示 SERPINA3 与全因死亡率显著相关（HR 1.41[95%1.19-1.68]，p < 0.001），但与心脏性死亡无关。调整后的关联无统计学意义。在 7 年随访时，332 例（38.1%）患者死亡。SERPINA3 与第三年起的全因死亡率独立相关。HR 为 1.14（95%CI，1.02-1.28），p = 0.022。类似的结果适用于联合终点，但分别不适用于 MI 和卒中。SERPINA3 的预后价值仅限于非 AMI 患者。在 AMI 患者中未观察到独立关联。
SERPINA3 预测长期全因死亡率，但不能预测 AMI 患者的结局。
