Shapira Maanit, Roguin Ariel, Fayad Ibraheem, Medlij Lina, Khateeb Aysha, Egbaria Dema, Amsalem Naama, Abu Fanne Rami
Division of laboratories, Hillel Yaffe Medical Center, Hadera, Israel.
Faculty of Medicine - Technion Israel Institute of Technology, Israel.
Int J Cardiol Heart Vasc. 2024 Jul 9;53:101465. doi: 10.1016/j.ijcha.2024.101465. eCollection 2024 Aug.
Inflammation plays a central role in atherogenesis. The major neutrophilic peptide alpha-defensin is a promising evolving risk factor for atherosclerosis. The aim of the present study was to examine the role of alpha-defensin in predicting future major adverse cardiovascular events (MACE) occurrence in fully revascularized patients with stable CAD under optimal medical therapy.
We retrospectively examined the prognostic value of baseline plasma alpha-defensin levels in predicting MACE occurrence in 174 fully revascularized patients for stable CAD between March 2016 and January 2017. Alpha-defensin levels were found 20 % higher among demised patients (10,859 pg/ml, IQR [6,920 to 23,320] vs. 9,020 pg/ml, IQR [5,540 to 16,180] pg/ml, P = 0.15). The absolute increase in mortality risk in patients with alpha-defensin levels greater than the median values was 72.5 % (P = 0.33). Log-rank analysis proved both recurrent PCI for de novo lesions (14.9 % and 2.3 %) and the composite of mortality and recurrent PCI for de novo lesions (27.6 % vs. 9.2 %) were significantly related to alpha-defensin values greater than the median (>9200 pg/ml).
Baseline plasma alpha-defensin is an independent predictor of mortality and recurrent PCI among patients with stable CAD. Alpha-defensin may evolve as a promising factor in cardiovascular risk assessment beyond traditional risk factors. Targeting alpha-defensin to ameliorate MACE occurrence should be addressed in future studies.
炎症在动脉粥样硬化形成过程中起核心作用。主要的中性粒细胞肽α-防御素是动脉粥样硬化一个有前景的、不断演变的风险因素。本研究的目的是探讨α-防御素在预测接受最佳药物治疗的稳定型冠心病完全血运重建患者未来发生主要不良心血管事件(MACE)中的作用。
我们回顾性研究了2016年3月至2017年1月期间174例接受稳定型冠心病完全血运重建患者的基线血浆α-防御素水平对预测MACE发生的预后价值。发现死亡患者的α-防御素水平高20%(10,859 pg/ml,IQR[6,920至23,320] vs. 9,020 pg/ml,IQR[5,540至16,180] pg/ml,P = 0.15)。α-防御素水平高于中位数的患者死亡风险的绝对增加为72.5%(P = 0.33)。对数秩分析表明,新发病变再次进行经皮冠状动脉介入治疗(14.9%和2.3%)以及新发病变的死亡和再次进行经皮冠状动脉介入治疗的复合事件(27.6%对9.2%)均与α-防御素值高于中位数(>9200 pg/ml)显著相关。
基线血浆α-防御素是稳定型冠心病患者死亡率和再次进行经皮冠状动脉介入治疗的独立预测因子。α-防御素可能成为超越传统风险因素的心血管风险评估中有前景的因素。未来研究应探讨针对α-防御素以改善MACE发生的问题。