Cell-free DNA levels as a prognostic marker in acute myocardial infarction
Cell-free DNA levels as a prognostic marker in acute myocardial infarction
复制标题
DOI：
10.1196/annals.1368.037
复制
发表时间：
2006-01-01
期刊：
影响因子：
--
通讯作者：
Tsigas, D.
中科院分区：
文献类型：
--
作者：
Antonatos, Dionisios;Patsilinakos, Sotirios;Tsigas, D.
源于细胞死亡的无细胞DNA在外周血液中循环。有迹象表明，心肌梗死有助于提高游离DNA水平。我们的目的是定量检测急性心肌梗死(AMI)患者的游离DNA水平，并检测其与心肌标记物和梗死后临床病程的相关性。13例急性心肌梗死患者，年龄57±16岁，在胸痛发作后6h内接受瑞替普酶溶栓治疗。于入院时及连续5天采集外周血样。分别于入院时、入院时每8h测定肌酸激酶(CK)和肌钙蛋白I(TnL)，连续3d。在整个住院期间记录临床事件。同时检测了30名健康对照的游离DNA水平。患者组最大游离DNA值的对数变换均值(+/-SE)高于对照组(6873+/-357G.E./mLvs 4112234G.E./mL.，P<；0.0001)。CK和TnI的对数转换最大值与第一天(r=0.62，P=0.02/r=0.68)和第二天(r=0.57，P=0.04/r=0.72，P=0.0053)的游离DNA值呈正相关。9例患者(A组)有简单的PI临床病程，4例(B组)有记录事件(3例有心绞痛，1例死亡)。第2天B组游离DNA水平高于A组(1298.0+/-796.0 g.e.m l比244.6+/-257.7 g.e/m L，P=0.003)。结论：急性心肌梗死患者的游离DNA水平显著高于对照组，并可能对患者的预后起作用。
Cell-free DNA that originates from cell death, circulates in peripheral blood. There are indications that the infarcted myocardium contributes to an increase of cell-free DNA levels. Our aims were to quantify levels of cell-free DNA in patients with acute myocardial infarction (AMI) and examine their correlation with myocardial markers and with postinfarction (PI) clinical course. Thirteen patients (age 57 +/- 16 year) admitted with AMI and who underwent thrombolysis with reteplase within 6 h from the onset of chest pain were studied. PB samples were collected on admission and for 5 consecutive days. Creatine kinase (CK) and troponin I (Tnl) were measured on admission and every 8 h for 3 consecutive days. Clinical events were recorded throughout the hospitalization period. Cell-free DNA levels were also measured in 30 healthy controls. Log-transformed mean (+/- SE) of maximum free DNA values in patients higher than controls (6873 +/- 357 g.e./mL verses 4112 234 g.e./mL, P < 0.0001). Log-transformed maximum values of CK and TnI were correlated with log-transformed free DNA values of first (r = 0.62, P = 0.02/r = 0.68, P = 0.01) and second (r = 0.57, P = 0.04/r = 0.72, P = 0.0053) PI day. Nine patients (group A) had an uncomplicated PI clinical course and four patients (group B) had recorded events (three with angina and one death). Free DNA levels on the second PI day were higher in group B than group A (1298.0 +/- 796.0 g.e./mL verses 244.6 +/- 257.7 g.e./mL, P = 0.003). In conclusion, free DNA levels are significantly higher in patients with AMI than in controls and may play a role in the prognosis of these patients.