Multiple biomarker use for detection of adverse events in patients presenting with symptoms suggestive of acute coronary syndrome
Multiple biomarker use for detection of adverse events in patients presenting with symptoms suggestive of acute coronary syndrome
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DOI：
10.1373/clinchem.2006.080192
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发表时间：
2007-05-01
影响因子：
9.3
通讯作者：
Murakami, MaryAnn M.
中科院分区：
文献类型：
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作者：
Apple, Fred S.;Pearce, Lesly A.;Murakami, MaryAnn M.
背景：我们研究了各种病理生理途径的多种生物标志物，以确定它们与急性冠状动脉综合征症状患者不良结局的关系。方法：我们采集了457例患者入院时的血浆标本，并测量了7种生物标志物：髓过氧化物酶（MPO）、可溶性CD40配体（CD40L）、胎盘生长因子（PIGF）、金属蛋白酶-9 （MMP-9）、高敏c反应蛋白（hsCRP）、心肌肌钙蛋白I （cTnI）和n端前b型利钠肽（NT-proBNP）。我们使用肾脏疾病饮食修正公式来计算估计的肾小球滤过率（eGFR）。终点是心脏事件（心肌梗死、经皮冠状动脉介入治疗、冠状动脉旁路移植术、心源性死亡）和全因死亡率。我们用Kaplan-Meier法估计了4个月期间的累积事件发生率，用Cox比例风险模型估计了相对风险（RR）。结果：PIGF、NT-proBNP、hsCRP或cTnI升高或eGFR降低的患者的全因死亡率比浓度在参考区间内的患者高11%至20%:20.4% （eGFR）、16.0% （PIGF）、15.8% （hsCRP）、12.7% （NT-proBNP）和11.3% (cTnI
Background: We investigated multiple biomarkers of various pathophysiologic pathways to determine their relationships with adverse outcomes in patients presenting with symptoms of acute coronary syndrome.Methods: We obtained plasma specimens from 457 patients on admission and measured 7 biomarkers: myeloperoxidase (MPO), soluble CD40 ligand (CD40L), placental growth factor (PIGF), metalloproteinase-9 (MMP-9), high-sensitivity C-reactive protein (hsCRP), cardiac troponin I (cTnI), and N-terminal pro-B-type natriuretic peptide (NT-proBNP). We used the Modification of Diet in Renal Disease formula to calculate the estimated glomerular filtration rate (eGFR). Endpoints were cardiac events (myocardial infarction, percutaneous coronary intervention, coronary artery bypass graft, cardiac death) and all-cause mortality. We estimated cumulative event rates over a 4-month period with the Kaplan-Meier method and relative risk (RR) with the Cox proportional hazards model.Results: Patients with increased PIGF, NT-proBNP, hsCRP, or cTnI or decreased eGFR had 11% to 20% higher all-cause mortality rates than patients with concentrations within reference intervals: 20.4% (eGFR), 16.0% (PIGF), 15.8% (hsCRP), 12.7% (NT-proBNP), and 11.3% (cTnI; all P