Effect of Serum Spermidine on the Prognosis in Patients with Acute Myocardial Infarction: A Cohort Study.
Effect of Serum Spermidine on the Prognosis in Patients with Acute Myocardial Infarction: A Cohort Study.
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作者：
背景：动物实验和人体研究发现，亚精胺是一种天然多胺，与心脏保护和延长寿命密切相关。目的：本研究旨在评估血清亚精胺水平对急性心肌梗死（AMI）患者预后的影响，并探讨氧化应激在上述关系中的潜在中介作用。方法：纳入 377 例 AMI 患者进行前瞻性队列研究，采用高效液相色谱荧光检测器和酶联免疫吸附法分别测定血清亚精胺和氧化应激指标（超氧化物歧化酶、谷胱甘肽过氧化物酶和丙二醛）。使用 Cox 比例风险模型评估亚精胺与 AMI 结局的关联。结果：在平均 12.3 ± 4.2 个月的随访期间，记录了 84 例 (22.3%) 主要不良心脏事件 (MACE)。经过多变量调整后，与对照组相比，血清亚精胺水平≥15.38 ng/mL (T3) 和 7.59–5.38 ng/mL (T2) 的参与者复发 AMI 的风险比 (HR) 分别为 0.450 [95% 置信区间 (CI): 0.213–0.984] 和 0.441 (95% CI: 0.215–0.907)。分别≤7.59 ng/mL (T1)。与 T1 相比，T3 和 T2 参与者的 MACE HR 分别为 0.566（95% CI：0.329-0.947）和 0.516（95% CI：0.298-0.893）。血清亚精胺水平与 MACE 风险之间观察到微弱的 J 形关联（p 非线性 = 0.036）。受试者操作特征曲线下面积的比较证实，包含血清亚精胺水平的模型比不包含血清亚精胺水平的模型具有更高的预测能力（0.733 与 0.701，p = 0.041）。超氧化物歧化酶对亚精胺和 MACE 之间的关联具有边际统计显着的中介作用 (p = 0.091)。结论：血清亚精胺与 AMI 个体预后的改善相关，但尚未发现氧化应激介导的潜在机制。
Background: Spermidine, a natural polyamine, was found critically involved in cardioprotection and lifespan extension from both animal experiments and human studies. Aims: This study aimed to evaluate the effect of serum spermidine levels on the prognosis in patients with acute myocardial infarction (AMI) and investigate the potential mediation effect of oxidative stress in the above relationship. Methods: We included 377 patients with AMI in a prospective cohort study and measured serum spermidine and oxidative stress indexes (superoxide dismutase enzymes, glutathione peroxidase, and Malondialdehyde) using high-performance liquid chromatography with fluorescence detector and enzyme-linked immunosorbent assay, respectively. The associations of spermidine with AMI outcomes were evaluated using Cox proportional hazards models. Results: 84 (22.3%) major adverse cardiac events (MACE) were documented during a mean follow-up of 12.3 ± 4.2 months. After multivariable adjustment, participants with serum spermidine levels of ≥15.38 ng/mL (T3) and 7.59–5.38 ng/mL (T2) had hazard ratio (HR) for recurrent AMI of 0.450 [95% confidence interval (CI): 0.213–0.984] and 0.441 (95% CI: 0.215–0.907) compared with the ≤7.59 ng/mL (T1), respectively. Participants in T3 and T2 had HR for MACE of 0.566 (95% CI: 0.329–0.947) and 0.516 (95% CI: 0.298–0.893) compared with T1. A faint J-shaped association was observed between serum spermidine levels and the risk of MACE (p-nonlinearity = 0.036). Comparisons of areas under receiver operator characteristics curves confirmed that a model including serum spermidine levels had greater predictive power than the one without it (0.733 versus 0.701, p = 0.041). A marginal statistically significant mediation effect of superoxide dismutase was shown on the association between spermidine and MACE (p = 0.091). Conclusions: Serum spermidine was associated with an improved prognosis in individuals with AMI, whereas the underlying mechanism mediated by oxidative stress was not found.
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影响因子：
5.3
作者：
LaRocca, Thomas J.;Gioscia-Ryan, Rachel A.;Hearon, Christopher M., Jr.;Seals, Douglas R.
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影响因子：
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2.6
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影响因子：
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影响因子：
7.3
作者：
Yan, Jing;Yan, Jian-Yun;Chen, Ai-Hua
通讯作者：
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