Cholecystokinin in plasma predicts cardiovascular mortality in elderly females
Cholecystokinin in plasma predicts cardiovascular mortality in elderly females
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DOI：
10.1016/j.ijcard.2016.02.038
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发表时间：
2016-04-15
影响因子：
3.5
通讯作者：
Alehagen, Urban
中科院分区：
文献类型：
--
作者：
Goetze, Jens P.;Rehfeld, Jens F.;Alehagen, Urban
工作背景：胆囊收缩素（cholestokinin，CCK）和胃泌素（gastrin）是两种胃肠激素，外源性给药对心血管有明显影响.目前尚不清楚内源性CCK或血浆胃泌素的测量是否包含关于心血管mortality.Methods的信息：死亡风险进行了评估，使用考克斯比例风险回归和Kaplan-Meier分析。评价了在初级保健环境中具有心脏病症状（即呼吸短促、外周水肿和/或疲劳）的老年患者（n = 470）。初级保健患者随访13年（从1999年），5年的全因和心血管死亡率被用作endpoint.Results：在单变量分析中，患者在第四CCK四分位数有5年心血管死亡的风险增加（风险比3.9，95%置信区间：2.1-7.0，p < 0.0001）。在多变量分析中，包括与心血管死亡相关的既定因素，第四四个四分位数的CCK浓度仍然与5年心血管死亡风险增加相关（HR 3.1，95% CI：1.7-5.7，p = 0.0004），即使在同一模型中包括第四四个四分位数NT-proBNP浓度。我们观察到了性别之间的显著差异，女性患者中第四个四分位数的CCK浓度与较高的5年心血管死亡率相关（HR 8.99，95% CI：3.49-102.82，p = 0.0007）与男性（1.47，95% CI：0.7-3.3，p = 0.35）。与此相反，没有显着的信息，从第四个四分位数的胃泌素浓度5年心血管mortality risk.Conclusions：CCK血浆中是一个独立的标志物，在老年女性患者的心血管死亡率。因此，本研究引入了血浆CCK的测量在性别特异性心血管风险评估。(C)2016爱思唯尔爱尔兰有限公司版权所有。
Background: Cholecystokinin (CCK) and gastrin are related gastrointestinal hormones with documented cardiovascular effects of exogenous administration. It is unknown whether measurement of endogenous CCK or gastrin in plasma contains information regarding cardiovascular mortality.Methods: Mortality risk was evaluated using Cox proportional hazard regression and Kaplan-Meier analyses. Elderly patients in a primary care setting with symptoms of cardiac disease, i.e. shortness of breath, peripheral edema, and/or fatigue, were evaluated (n = 470). Primary care patients were followed for 13 years (from 1999); the 5-year all-cause and cardiovascular mortality was used as end point.Results: In univariate analysis, patients in the 4th CCK quartile had an increased risk of 5-year cardiovascular mortality (hazard ratio 3.9, 95% confidence interval: 2.1-7.0, p < 0.0001). In multivariate analysis including established factors associated with cardiovascular mortality, CCK concentrations in the 4th quartile were still associated with increased 5-year cardiovascular mortality risk (HR 3.1, 95% C.I.: 1.7-5.7, p = 0.0004), even when including 4th quartile NT-proBNP concentrations in the same model. We observed a marked difference between the genders, where CCK concentrations in the 4th quartile were associated with a higher 5-year cardiovascular mortality in female patients (HR 8.99, 95% C.I.: 3.49-102.82, p = 0.0007) compared to men (1.47, 95% C.I.: 0.7-3.3, p = 0.35). In contrast, no significant information was obtained from 4th quartile gastrin concentrations on 5-year cardiovascular mortality risk.Conclusions: CCK in plasma is an independent marker of cardiovascular mortality in elderly female patients. The study thus introduces measurement of plasma CCK in gender-specific cardiovascular risk assessment. (C) 2016 Elsevier Ireland Ltd. All rights reserved.