Myeloid-related protein 8/14 and the risk of cardiovascular death or myocardial infarction after an acute coronary syndrome in the Pravastatin or Atorvastatin Evaluation and Infection Theraphy: Thrombolysis in Myocardial Infarction (PROVE IT-TIMI 22) trial
Myeloid-related protein 8/14 and the risk of cardiovascular death or myocardial infarction after an acute coronary syndrome in the Pravastatin or Atorvastatin Evaluation and Infection Theraphy: Thrombolysis in Myocardial Infarction (PROVE IT-TIMI 22) trial
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DOI：
10.1016/j.ahj.2007.08.018
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发表时间：
2008-01-01
影响因子：
4.8
通讯作者：
Simon, Daniel I.
中科院分区：
文献类型：
--
作者：
Morrow, David A.;Wang, Yunmei;Simon, Daniel I.
背景利用转录图谱方法，我们最近发现了髓系相关蛋白8/14(MRP-8/14)在急性心肌梗死(MI)时在血小板中表达。在表面健康的个体中，MRP-8/14浓度升高与未来心血管事件的风险较高相关，但尚未就急性冠脉综合征患者的预后进行评估。方法我们对参加普伐他汀或阿托伐他汀评估与感染的患者进行了嵌套式病例对照研究(n=237个病例对照)，以调查急性冠脉综合征后30天测量的与MRP-8/14相关的心血管死亡或心肌梗塞的风险。结果30天后发生心血管死亡或心肌梗死的患者MRP-8/14中位数[25，75百分位数]高于无复发事件患者(5.6[2.8，13.5]mg/L vs4.0[1.9，10.1]mg/L，P=0.020)。再发心血管事件的风险随着MRP-8/14每增加四分位数而增加(P趋势=0.007)，因此在调整标准风险指标、随机治疗和C反应蛋白后，水平最高的患者发生再发事件的几率增加2.0倍(95%可信区间1.1-3.6，P=0.029)。MRP-8/14和高敏C反应蛋白水平升高的患者与两者水平最低的患者相比，心血管死亡或心肌梗死的风险显著增加(调整后的优势比2.1，95%可信区间1.2-3.8)。结论髓系相关蛋白8/14可能是动脉粥样硬化血栓形成中血小板和炎症性疾病活动的有用生物标志物，并可能成为治疗干预的新靶点。
Background Using a transcriptional profiling approach, we recently identified myeloid-related protein 8/14 (MRP-8/14) to be expressed by platelets during acute myocardial infarction (MI). Elevated concentrations of MRP-8/14 are associated with a higher risk for future cardiovascular events in apparently healthy individuals but have not been assessed with respect to prognosis in patients with acute coronary syndrome. Methods We performed a nested case-control study (n = 237 case-control pairs) among patients enrolled in the Pravastatin or Atorvastatin Evaluation and Infection Theraphy: Thrombolysis in Myocardial Infarction 22 (PROVE IT-TIMI 22) trial (mean follow-up 24 months) to investigate the risk of cardiovascular death or MI associated with MRP-8/14 measured at 30 days after an acute coronary syndrome. Results Patients with cardiovascular death or MI after 30 days (cases) had higher median [25th, 75th percentile] MRP-8/14 levels than patients who remained free of recurrent events (5.6 [2.8, 13.5] mg/L vs 4.0 [1.9, 10.1] mg/L, P =.020). The risk of a recurrent cardiovascular event increased with each increasing quartile of MRP-8/1 4 (P-trend = 0.007) such that patients with the highest levels had a 2.0-fold increased odds (95% CI 1.1-3.6, P =.029) of a. recurrent event after adjusting for standard risk indicators, randomized treatment, and C-reactive protein. Patients with elevated levels of MRP-8/14 and high-sensitivity C-reactive protein showed significantly increased risk of cardiovascular death or MI compared with patients with the lowest levels of both markers (adjusted odds ratio 2.1, 95% CI 1.2-3.8). Conclusions Myeloid-related protein 8/14 may be a useful biomarker of platelet and inflammatory disease activity in atherothrombosis and may serve as a novel target for therapeutic intervention.