Associations among circulating levels of follistatin-like 1, clinical parameters, and cardiovascular events in patients undergoing elective percutaneous coronary intervention with drug-eluting stents
Associations among circulating levels of follistatin-like 1, clinical parameters, and cardiovascular events in patients undergoing elective percutaneous coronary intervention with drug-eluting stents
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DOI：
10.1371/journal.pone.0216297
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发表时间：
2019-04
期刊：
影响因子：
3.7
通讯作者：
Tatsuro Aikawa;K. Shimada;K. Miyauchi;Tetsuro Miyazaki;Eiryu Sai;Shohei Ouchi;Tomoyasu Kadoguchi;M. Kunimoto;Y. Joki;T. Dohi;S. Okazaki;K. Isoda;K. Ohashi;T. Murohara;N. Ouchi;H. Daida
中科院分区：
文献类型：
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作者：
Tatsuro Aikawa;K. Shimada;K. Miyauchi;Tetsuro Miyazaki;Eiryu Sai;Shohei Ouchi;Tomoyasu Kadoguchi;M. Kunimoto;Y. Joki;T. Dohi;S. Okazaki;K. Isoda;K. Ohashi;T. Murohara;N. Ouchi;H. Daida
卵泡抑素样1 （Follistatin-like 1, FSTL1）是骨骼肌细胞和心肌细胞分泌的一种糖蛋白。既往研究表明，急性冠脉综合征和慢性心力衰竭患者血清FSTL1浓度升高。本研究的目的是评估血浆FSTL1浓度与临床参数之间的关系，以及FSTL1浓度是否可以预测择期经皮冠状动脉介入治疗（PCI）患者的心血管事件。方法与结果对2004年8月至2006年12月在中山大学附属医院行选择性PCI合并药物洗脱支架（DES）的410例患者进行连续研究。我们在选择性PCI前测量血浆FSTL1水平，并评估FSTL1水平、临床参数和主要心脏或脑血管不良事件（MACCE）发生之间的关系，MACCE定义为心源性死亡、非致死性心肌梗死、不稳定性心绞痛、中风和因心力衰竭住院。FSTL1浓度与高敏c反应蛋白（hsCRP）、血清肌酐、n端前b型利钠肽呈正相关（均P < 0.01）。在排除肌酐清除率< 60 mL/min和hsCRP≥0.2 mg/dL的患者后，其余214例患者的随访时间中位数为5.1年。20例（9.3%）患者出现MACCE。受试者工作特征曲线分析估计FSTL1截止值为41.1 ng/mL，可预测MACCE的发生。Kaplan-Meier分析发现，FSTL1高（≥41.1 ng/mL）患者的MACCE率高于FSTL1低（< 41.1 ng/mL）患者（P < 0.01）。多因素Cox风险分析发现，高FSTL1是MACCE的独立预测因子（风险比4.54,95%可信区间：1.45 ~ 20.07,P < 0.01）。结论高血浆FSTL1可能是选择性PCI合并DES患者心血管事件的预测因子，特别是肾功能保留和低hsCRP患者。
Objectives Follistatin-like 1 (FSTL1) is a glycoprotein secreted by skeletal muscle cells and cardiac myocytes. Previous studies showed that serum FSTL1 concentrations were increased in acute coronary syndrome and chronic heart failure. The aim of this study was to assess the associations among plasma FSTL1 concentration, clinical parameters, and whether FSTL1 concentration could predict cardiovascular events in patients with elective percutaneous coronary intervention (PCI). Methods and results A consecutive series of 410 patients who underwent elective PCI with drug-eluting stents (DES) were enrolled between August 2004 and December 2006 at Juntendo University hospital. We measured plasma FSTL1 levels prior to elective PCI and assessed the association among FSTL1 levels, clinical parameters, and occurrence of major adverse cardiac or cerebrovascular events (MACCE) defined as cardiac death, nonfatal myocardial infarction, unstable angina, stroke, and hospitalization for heart failure. FSTL1 concentration was positively correlated with high-sensitivity C-reactive protein (hsCRP), serum creatinine, and N-terminal pro b-type natriuretic peptide (all P < 0.01). After excluding patients with creatinine clearance < 60 mL/min and hsCRP ≥ 0.2 mg/dL, the remaining 214 were followed for a median of 5.1 years. Twenty (9.3%) patients experienced MACCE. Receiver operating characteristics curve analysis estimated an FSTL1 cutoff of 41.1 ng/mL to predict MACCE occurrence. Kaplan–Meier analysis found a higher MACCE rate in patients with high (≥ 41.1 ng/mL) than with low (< 41.1 ng/mL) FSTL1 (P < 0.01). Multivariate Cox hazard analysis found that high FSTL1 was an independent predictor of MACCE (hazard ratio 4.54, 95% confidence interval: 1.45–20.07, P < 0.01). Conclusion High plasma FSTL1 may be a predictor of cardiovascular events in patients who underwent elective PCI with DES, especially with preserved renal function and low hsCRP.