Prognostic Significance of Activated Monocytes in Patients with ST-Elevation Myocardial Infarction.
Prognostic Significance of Activated Monocytes in Patients with ST-Elevation Myocardial Infarction.
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DOI：
10.3390/ijms241411342
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发表时间：
2023-07-12
影响因子：
5.6
通讯作者：
中科院分区：
文献类型：
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循环单核细胞有不同的亚群，包括经典（CD14++CD16−）、中间（CD14++CD16+）和非经典（CD14+CD16+），它们在心血管生理和疾病进展中起着不同的作用。每个亚群对冠状动脉疾病患者不良临床结局的预测价值尚不完全清楚。我们试图评估每个单核细胞亚群在st段抬高型心肌梗死（STEMI）患者中的预后效果。我们招募了100例经皮冠状动脉介入治疗（PCI）的STEMI患者。在患者到医院就诊时（出现症状后6小时内，基线（BL））以及就诊后3、6、12和24小时采集血样。将单核细胞定义为CD45+/HLA-DR+，然后根据CD14、CD16、CCR2、CD11b和CD42的表达进行细分。主要终点为全因死亡、心力衰竭住院、支架内血栓形成、支架内再狭窄和复发性心肌梗死。进行单因素和多因素Cox比例风险模型，包括基线合并症。我们队列的平均年龄为58.9岁，25%的患者为女性。与低水平的患者相比，CD14+CD16++单核细胞水平高（高于中位数）的患者出现主要终点的风险增加；CD14+/CD16++细胞的校正风险比（aHR）为4.3(95%可信区间（95% CI） 1.2 ~ 14.8, p = 0.02)， CD14+/CD16++/CCR2+细胞的校正风险比（aHR）为3.82 (95% CI 1.06 ~ 13.7, p = 0.04)， CD14+/CD16++/CD42b+细胞的校正风险比（aHR）为3.37 (95% CI 1.07 ~ 10.6, p = 0.03)， CD14+/CD16++/CD11b+的校正风险比（aHR）为5.17 (95% CI 1.4 ~ 18.0, p = 0.009)， CD14+ HLA-DR+的校正风险比（aHR）为7.5 （95% CI 2.0 ~ 28.5, p = 0.002）。CD14++CD16−、CD14++CD16+和它们的CD11b+、CCR2+和CD42b+聚集对我们的复合终点没有显著的预测作用。我们的研究表明，CD14+ CD16++单核细胞及其表达CCR2、CD42和CD11b的亚群可能是STEMI患者临床结局的重要预测因子。需要更大样本量和不同冠状动脉疾病表型的进一步研究来验证这一发现。
Circulating monocytes have different subsets, including classical (CD14++CD16−), intermediate (CD14++CD16+), and nonclassical (CD14+CD16++), which play different roles in cardiovascular physiology and disease progression. The predictive value of each subset for adverse clinical outcomes in patients with coronary artery disease is not fully understood. We sought to evaluate the prognostic efficacy of each monocyte subset in patients with ST-elevation myocardial infarction (STEMI). We recruited 100 patients with STEMI who underwent primary percutaneous coronary intervention (PCI). Blood samples were collected at the time of presentation to the hospital (within 6 h from onset of symptoms, baseline (BL)) and then at 3, 6, 12, and 24 h after presentation. Monocytes were defined as CD45+/HLA-DR+ and then subdivided based on the expression of CD14, CD16, CCR2, CD11b, and CD42. The primary endpoint was a composite of all-cause death, hospitalization for heart failure, stent thrombosis, in-stent restenosis, and recurrent myocardial infarction. Univariate and multivariate Cox proportional hazards models, including baseline comorbidities, were performed. The mean age of our cohort was 58.9 years and 25% of our patients were females. Patients with high levels (above the median) of CD14+CD16++ monocytes showed an increased risk for the primary endpoint in comparison to patients with low levels; adjusted hazard ratio (aHR) for CD14+/CD16++ cells was 4.3 (95% confidence interval (95% CI) 1.2–14.8, p = 0.02), for CD14+/CD16++/CCR2+ cells was 3.82 (95% CI 1.06–13.7, p = 0.04), for CD14+/CD16++/CD42b+ cells was 3.37 (95% CI 1.07–10.6, p = 0.03), for CD14+/CD16++/CD11b+ was 5.17 (95% CI 1.4–18.0, p = 0.009), and for CD14+ HLA-DR+ was 7.5 (95% CI 2.0–28.5, p = 0.002). CD14++CD16−, CD14++CD16+, and their CD11b+, CCR2+, and CD42b+ aggregates were not significantly predictive for our composite endpoint. Our study shows that CD14+ CD16++ monocytes and their subsets expressing CCR2, CD42, and CD11b could be important predictors of clinical outcomes in patients with STEMI. Further studies with a larger sample size and different coronary artery disease phenotypes are needed to verify the findings.
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自身蛋白毒素抑制可减少心脏炎症，并减轻心肌梗塞后心脏重塑。
影响因子：
5
作者：
Tripathi H;Al-Darraji A;Abo-Aly M;Peng H;Shokri E;Chelvarajan L;R Donahue R;Levitan BM;Gao E;Hernandez G;Morris AJ;Smyth SS;Abdel-Latif A
通讯作者：
Abdel-Latif A
影响因子：
5.5
作者：
Krychtiuk KA;Lenz M;Richter B;Hohensinner PJ;Kastl SP;Mangold A;Huber K;Hengstenberg C;Wojta J;Heinz G;Speidl WS
通讯作者：
Speidl WS
影响因子：
10.4
作者：
Tapp, L. D.;Shantsila, E.;Lip, G. Y. H.
通讯作者：
Lip, G. Y. H.
影响因子：
3.3
作者：
Ibanez, Borja;James, Stefan;Widimsky, Petr
通讯作者：
Widimsky, Petr
DOI：
10.1016/s0735-1097(01)01721-1
发表时间：
2002-01-16
影响因子：
24
作者：
Maekawa, Y;Anzai, T;Ogawa, S
通讯作者：
Ogawa, S