Clinical implications of elevated serum soluble CD137 levels in patients with acute coronary syndrome.
Clinical implications of elevated serum soluble CD137 levels in patients with acute coronary syndrome.
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急性冠脉综合征患者血清可溶性 CD137 水平升高的临床意义
DOI：
10.6061/clinics/2013(02)oa12
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Yang H
中科院分区：
文献类型：
--
作者：
Yan J;Wang C;Chen R;Yang H
动脉粥样硬化是一种慢性炎症性疾病。研究的重点是确定特定的血清生物标志物，以检测易损斑块。这些标志物可作为急性冠状动脉综合征的诊断工具，并有助于识别高危患者。然而，现有的数据是有限的和相互矛盾的。本研究验证了CD 137水平识别急性冠状动脉综合征患者复发心脏事件风险升高的假设。方法：采用正交试验设计应用酶联免疫吸附法测定180例急性冠脉综合征和120例急性胸痛患者血清可溶性CD 137（sCD 137）水平。通过流式细胞术评估血小板活化。采用受试者工作特征曲线分析sCD 137的预后特征。结果：75例急性冠脉综合征患者和20例急性胸痛患者血清sCD 137水平升高（> 35.0ng/ml）。在急性冠脉综合征患者中，sCD 137水平升高（>35.0 ng/ml）表明主要不良心血管事件的风险增加（OR = 1.93，95% CI：1.39-2.54）。 在30天、6个月和9个月的随访后，两组中血清sCD 137和cTnT水平升高与主要不良心血管事件的风险显著增加相关。sCD 137与肌钙蛋白I呈显著正相关（r = 0.4799，p<0.001）。 重要的是，26例cTnI水平正常的患者患有急性冠状动脉综合征。然而，升高的sCD 137水平将这些患者确定为高危亚组（OR = 2.14，95%CI：1.25-4.13）。 结论：sCD 137水平升高提示急性冠脉综合征患者心血管事件风险增加。可溶性CD 137可能是急性冠脉综合征患者不良事件的一个有用的预后标志物或指标。
OBJECTIVES: Atherosclerosis is a chronic inflammatory disease. Research has focused on identifying specific serum biomarkers to detect vulnerable plaques. These markers serve as diagnostic tools for acute coronary syndrome and assist in identifying high-risk patients. However, the existing data are limited and conflicting. This study tested the hypothesis that CD137 levels identify patients with acute coronary syndrome who are at a heightened risk for recurrent cardiac events. METHODS: The levels of soluble CD137 (sCD137) were measured using ELISA in 180 patients with acute coronary syndrome and 120 patients with acute chest pain. Platelet activation was assessed by flow cytometry. Receiver operating characteristic curve analysis was performed to evaluate the prognostic characteristics of sCD137. RESULTS: The levels of sCD137 were elevated in 75 patients with acute coronary syndromes and 20 patients with acute chest pain (>35.0 ng/ml). In patients with acute coronary syndrome, elevated sCD137 levels (>35.0 ng/ml) indicated an increased risk for major adverse cardiovascular events (OR = 1.93, 95% CI: 1.39-2.54). Elevated serum levels of sCD137 and cTnT were correlated with a significantly increased risk of major adverse cardiovascular events in both groups after 30 days, six months and nine months of follow-up. The increased sCD137 levels were significantly correlated with the levels of troponin I (r = 0.4799, p<0.001). Importantly, 26 patients with normal cTnI levels had acute coronary syndrome. However, elevated sCD137 levels identified these patients as a being high-risk subgroup (OR = 2.14, 95% CI: 1.25-4.13). CONCLUSIONS: Elevated sCD137 levels indicate an increased risk of cardiovascular events in patients with acute coronary syndrome. Soluble CD137 may be a useful prognostic marker or indicator for adverse events in patients with acute coronary syndrome.
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