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Perfiles biológicos en sujetos con eventos coronarios agudos recurrentes en comparación con sujetos con angina
P Bogaty1, P Poirier, S Simard
1Quebec Heart Institute/Laval Hospital, Laval University, Ste-Foy, Quebec, Canada.
Circulation
|June 27, 2001
Resumen
Un perfil inflamatorio, que incluye la proteína C reactiva (CRP), distingue a los pacientes con múltiples eventos coronarios agudos de aquellos con angina estable. Los niveles elevados de PCR predicen futuros eventos coronarios agudos en pacientes con enfermedad arterial coronaria.
Área de la Ciencia:
- Cardiología Cardiología.
- Los biomarcadores también son biomarcadores.
- La inflamación es la inflamación.
Sus antecedentes:
- La enfermedad de las arterias coronarias (CAD) presenta un espectro que va desde la angina estable hasta los eventos isquémicos agudos recurrentes.
- Distinguir estos extremos clínicos y predecir eventos agudos es clínicamente significativo.
Objetivo del estudio:
- Para probar si un perfil biológico específico diferencia a los pacientes con eventos coronarios agudos múltiples de aquellos con angina estable de larga duración.
- Para determinar si este perfil predice futuros eventos coronarios agudos.
Principales métodos:
- Comparación de biomarcadores sanguíneos que incluyen lipoproteína (((a), homocisteína, activador de plasminógeno tisular, inhibidor de activador de plasminógeno-1, proteína C reactiva (CRP), fibrinógeno y factor de von Willebrand.
- Se estudiaron tres grupos: eventos agudos múltiples, angina estable (>3 años) y controles sanos.
- Seguimiento durante 4.0 años para monitorear los eventos coronarios agudos.
Principales resultados:
- La lipoproteína, la homocisteína, la t-PA y la PAI-1 fueron similares en los grupos de CAD, pero más altas que en los controles.
- La PCR, el fibrinógeno y el factor de von Willebrand fueron significativamente más altos en el grupo de eventos agudos múltiples en comparación con el grupo de angina estable.
- Los eventos coronarios agudos (infarto de miocardio, angina inestable) ocurrieron en el 42% del grupo de eventos múltiples frente al 4% del grupo de angina estable.
- El análisis multivariado identificó la PCR como el único predictor significativo de eventos agudos de seguimiento (OR 5.9).
- Un valor basal de PCR >3,5 mg/L confirió un aumento de 7,6 veces en el riesgo de sucesos agudos posteriores.
Conclusiones:
- Un perfil biológico inflamatorio diferencia a los pacientes con antecedentes de múltiples eventos coronarios agudos de aquellos con angina estable de larga duración.
- El aumento de la proteína C reactiva (CRP) es un marcador clave que distingue a estos grupos y predice la futura inestabilidad coronaria aguda.
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