Prognostic differences of catestatin among young and elderly patients with acute myocardial infarction.

Wei-Xian Xu, Yuan-Yuan Fan, Yao Song, Xin Liu, Hui Liu, Li-Jun Guo
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Abstract

Background: Previous studies have reported inconsistent findings regarding the association between catestatin and outcomes of acute myocardial infarction (AMI). This study aims to investigate the prognostic value of catestatin for long-term outcomes in patients with AMI.

Methods: One hundred and sixty-five patients with AMI were enrolled in this series. The plasma catestatin levels at baseline and clinical data were collected. All patients were followed up for four years to investigate whether there were major adverse cardiovascular events (MACEs), including cardiovascular death, recurrent AMI, rehospitalization for heart failure, and revascularization.

Results: There were 24 patients who had MACEs during the follow-up period. The MACEs group had significantly lower plasma catestatin levels (0.74±0.49 ng/mL vs. 1.10±0.79 ng/mL, P=0.033) and were older (59.0±11.4 years old vs. 53.2±12.8 years old, P=0.036). The rate of MACEs was significantly higher in the elderly group (≥60 years old) than in the young group (<60 years old) (23.8% [15/63] vs. 8.8% [9/102], P=0.008). The catestatin level was significantly lower in the MACEs group than that in the non-MACEs group (0.76±0.50 ng/mL vs. 1.31±0.77 ng/mL, P=0.012), and catestatin was significantly associated with MACEs (Kaplan Meier, P=0.007) among the elderly group, but not in the young group (Kaplan Meier, P=0.893). In the Cox proportional hazards regression, high catestatin was one of the independent factors for predicting MACEs after adjustment for other risk factors (hazard ratio 0.19, 95% confidence interval 0.06-0.62, P=0.006) among elderly patients.

Conclusions: Elderly AMI patients with lower plasma catestatin levels are more likely to develop MACEs. Catestatin may be a novel marker for the long-term prognosis of AMI, especially in elderly patients.

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年轻和老年急性心肌梗死患者的 catestatin 预后差异。
背景:以往的研究对催产素与急性心肌梗死(AMI)预后的相关性报道不一。本研究旨在探讨睾酮对急性心肌梗死患者长期预后的预测价值:本系列研究共纳入 165 名急性心肌梗死患者。收集了基线时的血浆睾酮水平和临床数据。对所有患者进行了为期四年的随访,以调查是否发生了重大心血管不良事件(MACE),包括心血管死亡、AMI复发、心衰再住院和血管重建:在随访期间,有24名患者发生了MACE。MACEs组患者的血浆促血小板生成素水平明显较低(0.74±0.49 ng/mL vs. 1.10±0.79 ng/mL,P=0.033),年龄较大(59.0±11.4岁 vs. 53.2±12.8岁,P=0.036)。老年组(≥60 岁)的 MACE 发生率明显高于年轻组(P=0.008)。MACEs组的睾酮水平明显低于非MACEs组(0.76±0.50 ng/mL vs. 1.31±0.77 ng/mL,P=0.012),老年组的睾酮与MACEs明显相关(Kaplan Meier,P=0.007),但年轻组与MACEs无关(Kaplan Meier,P=0.893)。在Cox比例危险回归中,在调整其他危险因素后,高猫抑素是预测老年患者MACE的独立因素之一(危险比为0.19,95%置信区间为0.06-0.62,P=0.006):结论:血浆中猫促性腺激素水平较低的老年AMI患者更容易发生MACE。睾酮可能是AMI长期预后的一个新标记物,尤其是在老年患者中。
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