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急性心肌梗死后监测心脏状况的重要生物标志物。

Biomarkers of Importance in Monitoring Heart Condition After Acute Myocardial Infarction.

作者信息

Aleksova Aneta, Fluca Alessandra Lucia, Beltrami Antonio Paolo, Dozio Elena, Sinagra Gianfranco, Marketou Maria, Janjusevic Milijana

机构信息

Cardiothoracovascular Department, Azienda Sanitaria Universitaria Giuliano Isontina, 34100 Trieste, Italy.

Department of Medical Surgical and Health Sciences, University of Trieste, 34125 Trieste, Italy.

出版信息

J Clin Med. 2024 Dec 29;14(1):129. doi: 10.3390/jcm14010129.

Abstract

Despite notable advancements in cardiovascular medicine, morbidity and mortality rates associated with myocardial infarction (MI) remain high. The unfavourable prognosis and absence of robust post-MI protocols necessitate further intervention. In this comprehensive review, we will focus on well-established and novel biomarkers that can provide insight into the processes that occur after an ischemic event. More precisely, during the follow-up, it is of particular importance to monitor biomarkers that indicate an increase in myocardial stretch and stress, damage and death of cardiomyocytes, remodelling of the extracellular matrix, oxidative stress, and inflammation. This enables the identification of abnormalities in a timely manner, as well as the capacity to respond promptly to any changes. Therefore, we would like to highlight the importance of well-known markers, such as natriuretic peptides, high-sensitivity troponins, soluble suppression of tumorigenicity 2, galactin-3, C-reactive protein, and interleukins in post-MI settings, as well as biomarkers such as adrenomedullin, growth differentiation factor-15, insulin-like growth factor binding protein 7, amyloid beta, vitamin D, trimethylamine N-oxide, and advanced glycation end-products that recently emerged in the cardiovascular filed. The implementation of novel post-MI protocols, which encompass the monitoring of the aforementioned biomarkers deemed pertinent, in conjunction with adherence to established cardiac rehabilitation programmes, along with the already well-established therapeutic strategies and control of cardiovascular risk factors, has the potential to markedly enhance patient outcomes and reduce the elevated level of morbidity and mortality.

摘要

尽管心血管医学取得了显著进展,但与心肌梗死(MI)相关的发病率和死亡率仍然很高。预后不佳以及缺乏强有力的心肌梗死后治疗方案使得进一步干预成为必要。在这篇综述中,我们将重点关注已确立的和新出现的生物标志物,这些标志物能够深入了解缺血事件后发生的过程。更确切地说,在随访期间,监测那些表明心肌牵张和应激增加、心肌细胞损伤和死亡、细胞外基质重塑、氧化应激和炎症的生物标志物尤为重要。这能够及时发现异常情况,并能够对任何变化迅速做出反应。因此,我们想强调在心肌梗死后的情况下,诸如利钠肽、高敏肌钙蛋白、可溶性肿瘤抑制因子2、半乳糖凝集素-3、C反应蛋白和白细胞介素等知名标志物的重要性,以及诸如肾上腺髓质素、生长分化因子-15、胰岛素样生长因子结合蛋白7、淀粉样β蛋白、维生素D、氧化三甲胺和晚期糖基化终产物等最近在心血管领域出现的生物标志物的重要性。实施新的心肌梗死后治疗方案,包括监测上述被认为相关的生物标志物,同时坚持既定的心脏康复计划,以及已确立的治疗策略和控制心血管危险因素,有可能显著改善患者预后,降低发病率和死亡率的升高水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b2a/11721547/a4ee38e4e1f4/jcm-14-00129-g001.jpg

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