Qinghai Zhang, Xin He, Jing Ling, Qizhong Xiang, Minqi Li, Huiqi Zhao, Qinghua Fu, Yi Tang, Jin He, Wenjuan Fan, Yan Zhang, Hongwei Pan, Jianqiang Peng, Zhaofen Zheng
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引用次数: 2
Abstract
Plasma cell-free DNA (cfDNA) was elevated in patients with acute myocardial infarction (AMI) or heart failure (HF). However, whether cfDNA could serve as a predictor for risk of HF after AMI remains unknown. In this study, we conducted a pilot prospective cohort study in which 98 AMI patients were enrolled from a single center to assess the association between cfDNA levels at admission and risk of HF in an AMI population. Patients with cfDNA above the median level (14.39 ng/mL) showed higher low-density lipoprotein cholesterol, cardiac troponin I (cTnI), and soluble suppression of tumorigenicity 2 (sST2) levels compared with patients below the median. cfDNA was positively correlated with cTnI (r = 0.377, p < 0.001) and sST2 (r = 0.443, p < 0.001). Within a median follow-up of about 345 days, 46 patients (52.6%) developed HF. Multivariate Cox analysis showed that a higher cfDNA (above the cutoff value: 9.227 ng/mL) was an effective risk predictor (C-index = 0.74, 95% confidence interval [CI]: 0.733-0.748) for HF incidence after AMI (adjusted hazard ratio [HR]: 2.805; 95% CI: 1.087-7.242; p = 0.033). Moreover, a linear association was observed between cfDNA and risk of HF incidence adjusted for by age, gender, and history of chronic kidney disease (p for linear trend = 0.044). Taken together, the cfDNA levels at admission are associated with the incidence of HF in AMI patients. A positive correlation between cfDNA and the fibrotic factor sST2 was proved, but the underlying mechanisms require further study.
急性心肌梗死(AMI)或心力衰竭(HF)患者血浆游离DNA (cfDNA)升高。然而,cfDNA是否可以作为AMI后HF风险的预测因子仍然未知。在这项研究中,我们进行了一项前瞻性队列研究,从单个中心招募了98名AMI患者,以评估AMI人群入院时cfDNA水平与HF风险之间的关系。cfDNA高于中位数水平(14.39 ng/mL)的患者与低于中位数水平的患者相比,显示出更高的低密度脂蛋白胆固醇、心肌肌钙蛋白I (cTnI)和可溶性致瘤性2 (sST2)水平的抑制。cfDNA与cTnI呈正相关(r = 0.377, p r = 0.443, p p = 0.033)。此外,经年龄、性别和慢性肾脏疾病史校正后,cfDNA与HF发病风险之间存在线性关联(线性趋势p = 0.044)。综上所述,入院时cfDNA水平与AMI患者心衰发生率相关。cfDNA与纤维化因子sST2呈正相关,但其潜在机制有待进一步研究。
期刊介绍:
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