Increased monomeric CRP levels in acute myocardial infarction: A possible new and specific biomarker for diagnosis and severity assessment of disease
Increased monomeric CRP levels in acute myocardial infarction: A possible new and specific biomarker for diagnosis and severity assessment of disease
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DOI：
10.1016/j.atherosclerosis.2015.01.024
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发表时间：
2015-04-01
期刊：
影响因子：
5.3
通讯作者：
Guo, Yan
中科院分区：
文献类型：
--
作者：
Wang, Junhong;Tang, Bo;Guo, Yan
背景：单体C反应蛋白（mCRP）在动脉粥样硬化斑块破裂过程中起重要作用。近期有报道称mCRP与急性心肌梗死（AMI）相关。
目的：本研究旨在检测AMI患者中mCRP是否升高，并探讨将循环mCRP用作AMI诊断及疾病严重程度评估的生物标志物的可能性。
方法：制备了一种mCRP单克隆抗体，并验证其特异性。采用免疫荧光法评估mCRP在梗死心肌中的定位。此外，招募了101例AMI患者、38例不稳定型心绞痛（UAP）患者和41例稳定型心绞痛（SAP）患者，并招募43名健康志愿者作为对照。采集静脉血样本以测量循环mCRP、心肌肌钙蛋白T和超敏C反应蛋白（hs - CRP）水平。
结果：在模型小鼠的梗死心肌中观察到mCRP水平显著升高。此外，与UAP、SAP患者或对照患者（均为0 ng/ml，p < 0.001）相比，AMI患者血浆mCRP水平也显著升高（20.96 ± 1.64 ng/ml）。受试者工作特征（ROC）分析显示，循环mCRP对AMI具有较高的诊断准确性，曲线下面积（AUC）为0.928（95%置信区间为0.887 - 0.969）。此外，AMI组中有9例患者（9/101，8.91%）在30天随访前死亡，其血浆mCRP浓度显著高于存活患者（36.70 ± 10.26对比19.41 ± 1.43 ng/ml，P = 0.002）。
结论：这些结果表明，AMI患者中mCRP升高，循环mCRP可能是AMI疾病诊断及严重程度评估的潜在生物标志物。（C）2015爱思唯尔爱尔兰有限公司。保留所有权利。
Background: Monomeric CRP (mCRP) plays an important role in the process of atherosclerotic plaque rupture. Recently, it has been reported that mCRP was associated with acute myocardial infarction (AMI). Objectives: The aim of this study was to examine whether mCRP is increased in AMI patients and to investigate the possibility of using circulating mCRP as a biomarker for AMI diagnosis and severity assessment of disease.Methods: A mCRP monoclonal antibody was generated and verified for its specificity. Immunofluorescence was used to assess the localization of mCRP in the infarcted myocardium. Furthermore, 101 AMI, 38 unstable angina pectoris (UAP) and 41 stable angina pectoris (SAP) patients were enrolled, and 43 healthy volunteer were recruited as controls in the study. Venous blood samples were collected to measure the circulating mCRP, cardiac Troponin T and hs-CRP levels.Results: Significantly increased mCRP levels were observed in the infarcted myocardium of model mice. In addition, significantly increased plasma mCRP levels were also detected in AMI patients (20.96 +/- 1.64 ng/ml) compared to those with UAP, SAP or in control patients (all 0 ng/ml, p < 0.001). ROC analysis revealed that circulating mCRP had considerable diagnostic accuracy for AMI with an AUC of 0.928 (95% confidence interval 0.887-0.969). Furthermore, nine patients (9/101, 8.91%) in AMI group died before the 30-day follow-up, and their plasma mCRP concentration was significantly higher than those in surviving patients (36.70 +/- 10.26 vs. 19.41 +/- 1.43 ng/ml, P = 0.002).Conclusions: These results indicate that mCRP is increased in AMI and that circulating mCRP might be a potential biomarker for diagnosis and severity assessment of disease in AMI. (C) 2015 Elsevier Ireland Ltd. All rights reserved.