PDF(Pubmed)
Abstract：
UNASSIGNED: The complement system and neutrophil extracellular traps (NETs) might contribute to ischemia-reperfusion injury in ST-elevation myocardial infarction (STEMI). We aimed to estimate associations between complement activation and NETs in STEMI, and their prognostic value on clinical endpoints.
UNASSIGNED: In this cohort study, 864 patients admitted for PCI during STEMI were included. Complement activation was analyzed by the terminal complement complex (TCC), while NETs were analyzed by myeloperoxidase-DNA, citrullinated histone 3 (CitH3) and dsDNA. The composite endpoint was reinfarction, unscheduled revascularization, stroke, hospitalization due to heart failure, or death, and the secondary endpoint was total mortality. The association between TCC and clinical endpoints was assessed by Cox regression and ROC curve analysis.
UNASSIGNED: TCC was weakly correlated to dsDNA (r = 0.127, p < 0.001) and CitH3 (r = 0.102, p = 0.003). After a median follow-up time of 4.6 years, 184 (21.3 %) patients had reached a clinical endpoint. TCC was not associated with the composite endpoint, but with total mortality (HR: 1.673, 95 % CI: [1.014, 2.761], p = 0.044). The significant association was lost when adjusting for CRP, NT-proBNP, LVEF and time from symptoms to PCI. In ROC curve analysis of total mortality, the AUC for TCC alone was 0.549 (95 % CI: [0.472, 0.625]), AUC for dsDNA alone was 0.653 (95 % CI: [0.579, 0.720]), while AUC for TCC and dsDNA combined was 0.660 (95 % CI: [0.590, 0.730]).
UNASSIGNED: In this STEMI cohort, TCC was not associated with the composite endpoint, but somewhat with total mortality. Combining TCC and dsDNA did not increase the prognostic value compared to dsDNA alone.
UNASSIGNED: In this cohort study, 864 patients admitted for PCI during STEMI were included. Complement activation was analyzed by the terminal complement complex (TCC), while NETs were analyzed by myeloperoxidase-DNA, citrullinated histone 3 (CitH3) and dsDNA. The composite endpoint was reinfarction, unscheduled revascularization, stroke, hospitalization due to heart failure, or death, and the secondary endpoint was total mortality. The association between TCC and clinical endpoints was assessed by Cox regression and ROC curve analysis.
UNASSIGNED: TCC was weakly correlated to dsDNA (r = 0.127, p < 0.001) and CitH3 (r = 0.102, p = 0.003). After a median follow-up time of 4.6 years, 184 (21.3 %) patients had reached a clinical endpoint. TCC was not associated with the composite endpoint, but with total mortality (HR: 1.673, 95 % CI: [1.014, 2.761], p = 0.044). The significant association was lost when adjusting for CRP, NT-proBNP, LVEF and time from symptoms to PCI. In ROC curve analysis of total mortality, the AUC for TCC alone was 0.549 (95 % CI: [0.472, 0.625]), AUC for dsDNA alone was 0.653 (95 % CI: [0.579, 0.720]), while AUC for TCC and dsDNA combined was 0.660 (95 % CI: [0.590, 0.730]).
UNASSIGNED: In this STEMI cohort, TCC was not associated with the composite endpoint, but somewhat with total mortality. Combining TCC and dsDNA did not increase the prognostic value compared to dsDNA alone.
摘要：
■补体系统和中性粒细胞胞外陷阱（NETs）可能有助于ST段抬高型心肌梗死（STEMI）的缺血再灌注损伤。我们旨在评估STEMI中补体激活与NETs之间的关联，以及它们对临床终点的预后价值。
■在这项队列研究中，纳入STEMI期间接受PCI的864例患者。通过末端补体复合物（TCC）分析补体激活，而NETs是通过髓过氧化物酶-DNA分析的，瓜氨酸化组蛋白3(CitH3)和dsDNA。复合终点是再梗死，计划外血运重建,中风,因心力衰竭住院,或死亡，次要终点是总死亡率.通过Cox回归和ROC曲线分析评估TCC与临床终点之间的关联。
■TCC与dsDNA（r=0.127，p<0.001）和CitH3（r=0.102，p=0.003）弱相关。经过4.6年的中位随访时间，184例（21.3%）患者达到临床终点。TCC与复合终点无关，但总死亡率（HR：1.673，95%CI：[1.014，2.761]，p=0.044)。当调整CRP时，显著的关联消失了，NT-proBNP,LVEF和从症状到PCI的时间。在总死亡率的ROC曲线分析中，单独TCC的AUC为0.549（95%CI：[0.472，0.625]），单独dsDNA的AUC为0.653(95%CI:[0.579,0.720]),而TCC和dsDNA组合的AUC为0.660(95%CI:[0.590,0.730])。
■在此STEMI队列中，TCC与复合终点无关，但有点总死亡率。与单独的dsDNA相比,组合TCC和dsDNA没有增加预后价值。
■在这项队列研究中，纳入STEMI期间接受PCI的864例患者。通过末端补体复合物（TCC）分析补体激活，而NETs是通过髓过氧化物酶-DNA分析的，瓜氨酸化组蛋白3(CitH3)和dsDNA。复合终点是再梗死，计划外血运重建,中风,因心力衰竭住院,或死亡，次要终点是总死亡率.通过Cox回归和ROC曲线分析评估TCC与临床终点之间的关联。
■TCC与dsDNA（r=0.127，p<0.001）和CitH3（r=0.102，p=0.003）弱相关。经过4.6年的中位随访时间，184例（21.3%）患者达到临床终点。TCC与复合终点无关，但总死亡率（HR：1.673，95%CI：[1.014，2.761]，p=0.044)。当调整CRP时，显著的关联消失了，NT-proBNP,LVEF和从症状到PCI的时间。在总死亡率的ROC曲线分析中，单独TCC的AUC为0.549（95%CI：[0.472，0.625]），单独dsDNA的AUC为0.653(95%CI:[0.579,0.720]),而TCC和dsDNA组合的AUC为0.660(95%CI:[0.590,0.730])。
■在此STEMI队列中，TCC与复合终点无关，但有点总死亡率。与单独的dsDNA相比,组合TCC和dsDNA没有增加预后价值。
