在急性胸痛患者中,胎盘生长因子的预后值
Christopher Heeschen1, Stefanie Dimmeler, Stephan Fichtlscherer
1Department of Cardiology, Johann Wolfgang Goethe University, Frankfurt, Germany. c.heeschen@em.uni-frankfurt.de
JAMA
|January 30, 2004
概括
血中的胎盘生长因子 (PlGF) 是急性冠状动脉综合征 (ACS) 患者不良结果的强有力的预测因素. 测量plgf水平,以及热素t和可溶性cd40连接体,可以帮助识别心脏风险非常低的患者.
科学领域:
- 心脏病学 心脏病学
- 生物标志物发现发现
- 炎症研究 炎症研究
背景情况:
- 胎盘生长因子 (PlGF) 是血管内皮生长因子家族的成员,与动脉样硬化斑块的不稳定性有关.
- 实验数据表明,PLGF的作用是动脉样硬化的炎症诱因.
- 在急性冠状动脉综合征 (ACS) 中,plGF可能作为一种有价值的风险预测生物标志物.
研究的目的:
- 调查血PlGF水平是否可以预测急性胸痛患者的死亡或非致命心肌梗塞风险.
- 在ACS的背景下,评估PlGF作为预后生物标志物.
主要方法:
- 在两个队列中测量了plGF水平:547名来自CAPTURE试验的ACS患者和626名急性胸痛患者.
- 其他测量到的生物标志物包括素T (TnT),可溶性CD40配体 (sCD40L) 和高灵敏性C反应蛋白 (hsCRP).
- 评估的主要结果是30天内死亡或非致命心肌梗塞的风险.
主要成果:
- 在ACS患者中,升高的PLGF水平 (>27.0 ng/L) 显著增加了30天事件的风险 (14.8%与4.9%相比).
- 在多变量分析中,高的PlGF,TnT和sCD40L是不良事件的独立预测因素,而hsCRP则不是.
- 在患有急性胸痛的患者中,升高的PLGF独立预测风险 (调整HR,3.00).
- 对TnT,sCD40L和PlGF负的患者表现出非常低的心脏风险.
结论:
- 血PlGF水平是可疑ACS患者不良结果的独立生物标志物.
- 最初的血PlGF测量增强了超越传统炎症标志物的预测和预后信息.
- 结合PlGF,TnT和sCD40L可以有效地识别低风险个体.
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