Serum levels of the interleukin-1 receptor family member ST2 predict mortality and clinical outcome in acute myocardial infarction
Serum levels of the interleukin-1 receptor family member ST2 predict mortality and clinical outcome in acute myocardial infarction
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DOI：
10.1161/01.cir.0000127958.21003.5a
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发表时间：
2004-05-11
期刊：
影响因子：
37.8
通讯作者：
Lee, RT
中科院分区：
文献类型：
--
作者：
Shimpo, M;Morrow, DA;Lee, RT
背景——机械超负荷的心肌细胞会分泌一种可溶性白细胞介素 1 受体家族成员，称为 ST2。血清ST2水平与非缺血性心力衰竭的预后相关，但ST2对急性心肌梗死患者的预测价值尚不清楚。 方法和结果-在心肌梗死溶栓治疗（TIMI）14（362名患者）以及依诺肝素和TNK-tPA联合或不联合的情况下，测量了810名急性心肌梗死患者的血清ST2水平 GPIIb/IIIa 抑制剂作为 STEMI (ENTIRE)-TIMI 23（448 名患者）临床试验中的再灌注策略。 30 天后死亡的患者（0.379 与 0.233 ng/mL，P=0.0001）或出现新的充血性心力衰竭（0.287 与 0.233 ng/mL，P=0.009）的患者 ST2 基线水平显着较高。在按 ST2 四分位数对 30 天结果进行的分析中，死亡 (P=0.001) 和死亡/心力衰竭合并终点 (P=0.001) 均显示出与 ST2 水平显着的分级相关性；此外，院内死亡（P=0.003）和死亡/心力衰竭（P=0.004）也与较高的 ST2 水平显着相关。在控制重要临床因素的逻辑回归分析中，ST2 水平升高仍然与 30 天死亡相关（P=0.047）。 ST2 水平在梗死后第一天上升，并在 12 小时时达到最高值； 12 小时时的 ST2 水平也与 30 天时的死亡独立相关（P
Background-Mechanically overloaded cardiomyocytes secrete a soluble interleukin-1 receptor family member called ST2. Serum levels of ST2 are associated with prognosis in nonischemic heart failure, but the predictive value of ST2 in patients with acute myocardial infarction is unknown.Methods and Results-ST2 levels were measured in serum from 810 patients with acute myocardial infarction in the Thrombolysis In Myocardial Infarction (TIMI) 14 (362 patients) and Enoxaparin and TNK-tPA With or Without GPIIb/IIIa Inhibitor as Reperfusion Strategy in STEMI (ENTIRE)-TIMI 23 ( 448 patients) clinical trials. Baseline levels of ST2 were significantly higher in those patients who died (0.379 versus 0.233 ng/mL, P=0.0001) or developed new congestive heart failure (0.287 versus 0.233 ng/mL, P=0.009) by 30 days. In an analysis of outcomes at 30 days by ST2 quartiles, both death (P=0.001) and the combined death/heart failure end point (P=0.001) showed a significant graded association with levels of ST2; furthermore, in-hospital death (P=0.003) and death/heart failure (P=0.004) were also significantly associated with higher ST2 levels. In a logistic regression analysis that controlled for important clinical factors, increasing levels of ST2 remained associated with death at 30 days (P=0.047). ST2 levels rose during the first day after infarction and were maximal at 12 hours; ST2 levels at 12 hours were also independently associated with death at 30 days (P