Hartopo Anggoro B, Mayasari Dyah S, Puspitawati Ira, Putri Astrid K, Setianto Budi Y
Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada-Dr. Sardjito Hospital, Yogyakarta, Indonesia.
Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada - UGM Academic Hospital, Yogyakarta, Indonesia.
Int J Angiol. 2024 Apr 2;33(4):288-296. doi: 10.1055/s-0044-1785488. eCollection 2024 Dec.
Endothelial-derived microparticles (EDMP) are markers of vascular function and convey roles in coagulation, inflammation, vasoactivity, angiogenesis, and cellular apoptosis, which implicate acute myocardial infarction (AMI). This study aimed to investigate whether, among AMI, on-admission EDMP counts affect hospital major adverse cardiovascular events (MACE) and whether the change of EDMP in 30-day posthospital discharge affects long-term follow-up MACE. The research design was a prospective cohort study. The subjects were 119 patients diagnosed and hospitalized with AMI, who were enrolled consecutively. The EDMP was measured on hospital admission and repeated 30-day posthospital discharge. The outcomes were in the hospital MACE comprised of cardiac mortality, heart failure, cardiogenic shock, reinfarction, and resuscitated ventricular arrhythmia. Furthermore, long-term follow-up were performed on 30-day, 90-day, and 1-year posthospital AMI discharge. The on-admission EDMP counts were significantly higher in subjects with hospital MACE compared with those without (median [interquartile range]: 27,421.0 [6,956.5-53,184.0] vs. 11,617.5 [4,599.0-23,336.7] counts/µL, = 0.028). The EDMP counts cutoff value of >26,810.0 counts/µL (52.4% sensitivity, 81.6% specificity) had significantly increased hospital MACE occurrence (adjusted odd ratio: 4.45, 95% confidence interval: 1.47-13.53, = 0.008). The EDMP counts were significantly increased after 30-day posthospital discharge. Both on-admission and 30-day EDMP counts and the changes in EDMP counts did not impact MACE on the long-term follow-up. In conclusion, higher on-admission EDMP counts were independently associated with hospital MACE among AMI. However, on-admission and 30-day postdischarge EDMP and their changes did not impact long-term follow-up MACE.
内皮源性微粒(EDMP)是血管功能的标志物,在凝血、炎症、血管活性、血管生成和细胞凋亡中发挥作用,这些均与急性心肌梗死(AMI)相关。本研究旨在调查在AMI患者中,入院时的EDMP计数是否会影响医院主要不良心血管事件(MACE),以及出院后30天内EDMP的变化是否会影响长期随访的MACE。研究设计为前瞻性队列研究。研究对象为119例确诊并因AMI住院的患者,这些患者是连续入组的。在入院时测量EDMP,并在出院后30天重复测量。观察指标为院内MACE,包括心源性死亡(心源死)、心力衰竭、心源性休克、再梗死和复苏的室性心律失常。此外,在AMI出院后30天、90天和1年进行长期随访。与无院内MACE的患者相比,有院内MACE的患者入院时的EDMP计数显著更高(中位数[四分位间距]:27,421.0[6,956.5 - 53,184.0]个/微升 vs. 11,617.5[4,599.0 - 23,336.7]个/微升,P = 0.028)。EDMP计数临界值>26,810.0个/微升(敏感性52.4%,特异性81.6%)时,院内MACE的发生率显著增加(校正比值比:4.45,95%置信区间:1.47 - 13.53,P = 0.008)。出院后30天EDMP计数显著增加。入院时和出院后30天的EDMP计数以及EDMP计数的变化均未影响长期随访的MACE。总之,在AMI患者中,入院时较高的EDMP计数与院内MACE独立相关。然而,入院时和出院后30天的EDMP及其变化并未影响长期随访的MACE。