Procollagen III N-Terminal Peptide Predicts Short-Term Prognosis and Cardiac Remodeling in Coronary Heart Disease Patients With Metabolic Syndrome
Procollagen III N-Terminal Peptide Predicts Short-Term Prognosis and Cardiac Remodeling in Coronary Heart Disease Patients With Metabolic Syndrome
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DOI：
10.1097/maj.0b013e3181f080d8
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发表时间：
2011-01-01
影响因子：
3.1
通讯作者：
Wu, Zhi-Qin
中科院分区：
文献类型：
--
作者：
Deng, Wei;Chen, Qing-Wei;Wu, Zhi-Qin
简介：许多冠心病患者同时伴有代谢综合征，但对这些患者的心血管重构状况知之甚少。本研究旨在探讨血浆III型前胶原N端肽（PIIINP）在预测CHD合并MS患者预后和心脏重塑中的作用。方法：根据血浆PIIINP的中位数将108例患者分为高、低PIIINP组。随访1年前后进行心血管检查，包括超声心动图、颈动脉彩超、冠状动脉造影和6分钟步行试验（6 MWT）。在随访期间评估因心脏和脑血管事件再次入院的情况。结果如下：多元逐步回归分析显示，血浆PIIINP水平与年龄、高敏C反应蛋白（hs-CRP）和体重指数显著相关。偏相关分析显示LnPIIINP与左室重量指数增加呈正相关。考克斯比例风险模型分析表明，PIIINP、左室射血分数和hs-CRP水平是随访期间因心脑血管事件再入院的独立预测因素。PIIINP值为4.0 μ g/L是确定是否需要再入院的最佳阈值。结论：在CHD合并MS患者中，PIIINP水平随年龄、hs-CRP和体重指数的增加而升高，高水平的PIIINP表明近期心脏重塑和运动耐量恶化以及预后不良。
Introduction: Many patients with coronary heart disease (CHD) also have metabolic syndrome (MS); however, little is known about the condition of cardiovascular remodeling in these patients. The objective of this study to explore the role of plasma procollagen III N-terminal peptide (PIIINP) in predicting the prognosis and cardiac remodeling in patients with CHD with MS. Methods: One hundred eight patients were classified into high and low PIIINP groups according to the median value of plasma PIIINP. Cardiovascular examinations including echocardiogram, carotid color ultrasound examination, coronary angiography and the 6-minute walking test (6MWT) were performed before and after a 1-year follow-up. Readmission for cardiac and cerebrovascular events was assessed during the follow-up period. Results: Plasma PIIINP level was significantly correlated with age, high-sensitivity C-reactive protein (hs-CRP) and body mass index in a multiple stepwise regression model. There was a positive correlation between the LnPIIINP and an increased left ventricular mass index in partial correlation analysis. The Cox proportional hazard model analysis indicated that the level of PIIINP, left ventricular ejection fraction and hs-CRP were independent predictors of readmission owing to cardiac and cerebrovascular events during the follow-up. A PIIINP value of 4.0 mu g/L was the best threshold value for determining the need for readmission. Conclusions: PIIINP levels rise with increases in age, hs-CRP and body mass index in patients with CHD with MS, and a high level of PIIINP indicates recent deterioration of cardiac remodeling and exercise tolerance and a poor prognosis.