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心肌缺血再灌注损伤后NLRP3外周血水平与甘油三酯-葡萄糖指数之间的预后相关性。

Correlation between prognosis and peripheral blood levels of NLRP3 and triglyceride-glucose index after myocardial ischemia-reperfusion injury.

作者信息

Yao Lingling, Li Bing, Zhang Fusheng, Ke Qun, Gong Yong

机构信息

Cardiac Care Unit(CCU), Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China.

出版信息

J Cardiothorac Surg. 2024 Oct 1;19(1):553. doi: 10.1186/s13019-024-03068-0.

Abstract

OBJECTIVE

We aim to investigate the association between prognosis and outcomes following myocardial ischemia-reperfusion injury, as well as peripheral blood levels of NLRP3 and the triglyceride-glucose index (TyG).

METHODS

A total of 100 patients who underwent emergency coronary intervention following myocardial infarction confirmed by coronary angiography at our hospital between October 2021 and May 2023 were included in this study. Patients were stratified into two groups based on their prognoses: the control group (n = 73), which did not experience new myocardial infarctions or require hospitalization for heart failure or suffer sudden cardiac death post-interventional treatment; and the observation group (n = 27), which experienced one or more cardiovascular events post-treatment. Patient demographics were obtained from clinical records while biochemical analyses assessed peripheral blood triglycerides, blood glucose levels, and TyG index. Additionally, ELISA measurements determined levels of NLRP3 as well as inflammatory factors IL-6, TNF-α, and CRP in peripheral blood samples. Cardiac function was evaluated according to NYHA standards. Univariable Cox regression analysis identified factors influencing patient prognosis while Pearson correlation analysis examined relationships among prognosis, outcomes following myocardial ischemia-reperfusion injury, TyG index, and peripheral blood NLRP3.

RESULTS

No significant differences were observed in the general characteristics between the two patient groups (P > 0.05). However, the observation group exhibited higher levels of peripheral blood triglycerides, blood glucose, and TyG index compared to the control group (P < 0.05). Additionally, levels of NLRP3 and inflammatory factors IL-6, TNF-α, and CRP were elevated in the observation group compared to the control group (P < 0.05). Cardiac function impairment was more pronounced in the observation group (P < 0.05). Notably, TyG index and peripheral blood NLRP3 demonstrated higher risk ratios compared to other biomarkers (P < 0.05), indicating their significance in prognosis and outcomes. Elevated levels of NLRP3 and TyG index were associated with poorer recovery of cardiac function, increased rehospitalization rates, and higher mortality (P < 0.05).

CONCLUSION

Elevated NLRP3 levels and an increased TyG index are strongly associated with impaired cardiac function and heightened risk of cardiovascular events. These findings suggest that these biomarkers may serve as crucial prognostic indicators following myocardial ischemia-reperfusion injury.

摘要

目的

我们旨在研究心肌缺血再灌注损伤后的预后与结局之间的关联,以及外周血中NLRP3和甘油三酯-葡萄糖指数(TyG)的水平。

方法

本研究纳入了2021年10月至2023年5月期间在我院因冠状动脉造影确诊心肌梗死后接受急诊冠状动脉介入治疗的100例患者。根据患者的预后将其分为两组:对照组(n = 73),在介入治疗后未发生新的心肌梗死,未因心力衰竭住院或发生心源性猝死;观察组(n = 27),在治疗后发生了一次或多次心血管事件。患者的人口统计学数据来自临床记录,同时生化分析评估外周血甘油三酯、血糖水平和TyG指数。此外,酶联免疫吸附测定(ELISA)法测定外周血样本中NLRP3以及炎症因子白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和C反应蛋白(CRP)的水平。根据纽约心脏协会(NYHA)标准评估心功能。单因素Cox回归分析确定影响患者预后的因素,Pearson相关分析检验预后、心肌缺血再灌注损伤后的结局、TyG指数和外周血NLRP3之间的关系。

结果

两组患者的一般特征无显著差异(P > 0.05)。然而,与对照组相比,观察组外周血甘油三酯、血糖和TyG指数水平更高(P < 0.05)。此外,与对照组相比,观察组中NLRP3以及炎症因子IL-6、TNF-α和CRP的水平升高(P < 0.05)。观察组的心功能损害更为明显(P < 0.05)。值得注意的是,与其他生物标志物相比,TyG指数和外周血NLRP3显示出更高的风险比(P < 0.05),表明它们在预后和结局中的重要性。NLRP3水平升高和TyG指数升高与心功能恢复较差、再住院率增加和死亡率较高相关(P < 0.05)。

结论

NLRP3水平升高和TyG指数增加与心功能受损和心血管事件风险增加密切相关。这些发现表明,这些生物标志物可能是心肌缺血再灌注损伤后关键的预后指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ec8/11443841/c41ef5d12473/13019_2024_3068_Fig1_HTML.jpg

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