Zuo Guangfeng, Zhang Juan, Xie Hao
Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Qinhuai, Nanjing, 210006, China.
BMC Cardiovasc Disord. 2024 Dec 19;24(1):709. doi: 10.1186/s12872-024-04391-z.
Angiopoietin-like protein 2 (Angptl2) is a cytokine that is released to stimulate inflammation and accelerate atherogenesis. Our study sought to assess the predictive significance of serum Angptl2 in individuals diagnosed with acute coronary syndrome (ACS) and determine whether it can enhance prognostic performance beyond the GRACE risk score.
We recruited a total of 1060 patients with ACS in a consecutive manner. The levels of Angptl2 in serum were analyzed at baseline. The subjects were then followed up for 12 months to monitor the occurrence of major adverse cardiovascular events (MACE).
The level of serum Angptl2 showed a positive correlation with the GRACE score (r = 0.54, p < 0.001). Survival analysis revealed that increased levels of serum Angptl2 were associated with higher occurrence of the composite of MACE (log-rank p < 0.001) and its specific components (log-rank p = 0.011 for all-cause death, p = 0.007 for non-fatal myocardial infarction and p < 0.001 for revascularization respectively). Throughout the follow-up period, 163 instances (15.4%) of endpoint events were documented. In terms of MACE, both serum Angptl2 levels (HR: 1.178, 95% CI: 1.058-1.313, p = 0.003) and the GRACE risk score (HR: 1.181, 95% CI: 1.007-1.385, p = 0.041) emerged as significant predictors following Cox multivariate adjustment. Additionally, the addition of serum Angptl2 to the GRACE score improved the predictive capacity for prognosis [increase in area under the receiveroperating characteristic curve (AUC) from 0.740 to 0.794, p = 0.020; net reclassification improvement (NRI) = 0.401, p = 0.001; integrated discrimination improvement (IDI) = 0.022, p = 0.008].
Serum Angptl2 might be a useful prognostic biomarker and combining serum Angptl2 with the GRACE score increased the efficacy of prognosis prediction in ACS patients.
Not applicable.
血管生成素样蛋白2（Angptl2）是一种细胞因子，可释放以刺激炎症并加速动脉粥样硬化的发生。我们的研究旨在评估血清Angptl2在诊断为急性冠状动脉综合征（ACS）的个体中的预测意义，并确定它是否能在GRACE风险评分之外提高预后预测性能。
我们连续招募了总共1060例ACS患者。在基线时分析血清中Angptl2的水平。然后对受试者进行12个月的随访，以监测主要不良心血管事件（MACE）的发生情况。
血清Angptl2水平与GRACE评分呈正相关（r = 0.54，p < 0.001）。生存分析显示，血清Angptl2水平升高与MACE复合终点事件的更高发生率相关（对数秩检验p < 0.001）及其特定组成部分（全因死亡的对数秩检验p = 0.011，非致命性心肌梗死的对数秩检验p = 0.007，再血管化的对数秩检验p < 0.001）。在整个随访期间，记录了163例（15.4%）终点事件。就MACE而言，经Cox多变量调整后，血清Angptl2水平（HR：1.178，95%CI：1.058 - 1.313，p = 0.003）和GRACE风险评分（HR：1.181，95%CI：1.007 - 1.385，p = 0.041）均成为显著的预测因素。此外，将血清Angptl2添加到GRACE评分中可提高预后预测能力[受试者工作特征曲线下面积（AUC）从0.740增加到0.794，p = 0.020；净重新分类改善（NRI） = 0.401，p = 0.001；综合判别改善（IDI） = 0.022，p = 0.008]。
血清Angptl2可能是一种有用的预后生物标志物，将血清Angptl2与GRACE评分相结合可提高ACS患者预后预测的效能。
不适用。
