Inflammatory protein levels and depression screening after coronary stenting predict major adverse coronary events.
Inflammatory protein levels and depression screening after coronary stenting predict major adverse coronary events.
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DOI：
10.1177/1099800409332801
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发表时间：
2009-10
影响因子：
2.5
通讯作者：
Boerwinkle E
中科院分区：
文献类型：
--
作者：
Frazier L;Vaughn WK;Willerson JT;Ballantyne CM;Boerwinkle E
在确诊为心脏病的患者中，传统的危险因素不能解释未来主要不良冠状动脉事件(MACE)的大多数。我们检查了炎症蛋白水平作为未来MACE的可能预测因子，以及启动炎症蛋白水平暂时性升高的生理和心理因素。490例患者在择期冠状动脉支架置入后4-12小时采集外周血样和抑郁数据。抑郁筛查通过单问题筛查工具进行评估。使用生存分析对未来MACE进行预测建模，从指标事件(支架放置)到未来MACE的时间作为因变量。高敏C反应蛋白(HsCRP)在第二和第三四分位数的患者发生MACE的可能性分别是第一四分位高敏C反应蛋白(HsCRP)患者的3和2.5倍。随着血管细胞黏附分子和单核细胞趋化蛋白-1水平的升高，未来发生MACE的风险也随之增加。在支架置入后24个月内，抑郁症筛查阳性的患者发生MACE的可能性大约是未筛查阳性的患者的2倍。我们的结果表明，冠心病患者冠状动脉支架置入后hsCRP、血管细胞黏附分子和单核细胞趋化蛋白-1水平的测定可以预测未来的MACE。此外，阳性抑郁筛查是未来MACE的独立预测因素。
Traditional risk factors cannot account for the majority of future major adverse coronary events (MACE) in patients diagnosed with heart disease. We examined levels of inflammatory proteins to be possible predictors of future MACE and physiological and psychological factors that initiate temporal increases in inflammatory protein levels. Peripheral blood samples and depression data were collected 4 to 12 hr after elective coronary stent insertion in 490 patients. Depression screening was assessed by a single-question screening tool. Predictive modeling for future MACE was performed by using survival analysis, with time from the index event (placement of the stent) to future MACE as the dependent variable. Patients with high-sensitivity c-reactive protein (hsCRP) in the second and third quartiles were 3 and 2.5 times more likely to have a MACE than patients with hsCRP in the first quartile, respectively. As levels of vascular cell adhesion molecule and monocyte chemoattractant protein-1 increased, so did the risk of future MACE. Patients who screened positive for depression were approximately 2 times more likely to have a MACE within 24 months after stent placement than were patients who did not screen positive. Our results suggest that hsCRP, vascular cell adhesion molecule, and monocyte chemoattractant protein-1 levels, measured after coronary stent insertion in patients with coronary heart disease, are prognostic of future MACE. Furthermore, positive depression screening is an independent predictor of future MACE.
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影响因子：
39.2
作者：
Berg, AO;Allan, JD;Woolf, SH
通讯作者：
Woolf, SH
影响因子：
37.8
作者：
Liuzzo, G;Buffon, A;Maseri, A
通讯作者：
Maseri, A
影响因子：
2.8
作者：
Gaspardone, A;Crea, F;Gioffrè, PA
通讯作者：
Gioffrè, PA
影响因子：
17.7
作者：
Lespérance, F;Frasure-Smith, N;Irwin, M
通讯作者：
Irwin, M
影响因子：
5.9
作者：
Kini, AS;Lee, PC;Sharma, SK
通讯作者：
Sharma, SK