Tryptase as a Biomarker for Adverse Prognosis in ST-Segment Elevation Myocardial Infarction Patients: A Prospective Cohort Study.

IF 4.2 2区医学 Q2 IMMUNOLOGY

Journal of Inflammation Research Pub Date : 2025-03-14 eCollection Date: 2025-01-01 DOI:10.2147/JIR.S502496

Pengxin Xie, Shuwan Xu, Xi Chen, Hong Xu, Ruitao Zhang, Dan Li, Lijie Sun, Dan Zhu, Ming Cui

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引用次数: 0

Abstract

Background: Acute ST-segment elevation myocardial infarction (STEMI) is characterized by a rapid inflammatory response, with mast cells (MCs) playing a significant role. However, the relationship between MC activation and the adverse outcomes remains unclear. This study investigated the association between the MC activation biomarker, tryptase, and major adverse cardiovascular events (MACE).

Methods: This prospective study included patients with STEMI who underwent primary percutaneous coronary intervention (PPCI) at Peking University Third Hospital between July 2020 and July 2023. Tryptase levels were detected from plasma samples collected 6 hours post-PPCI and using ELISA method. All patients were followed up every 6 months, with MACE as the primary endpoint.

Results: The study enrolled 514 patients with STEMI who underwent PPCI (mean age: 59.27 ± 13.26 years, 16.93% female). The median follow-up time was 13.28 (10.47-37.61) months, during which 85 patients (16.54%) experienced MACE. Patients in the higher tryptase group had a higher risk of MACE (HR 2.60 [1.68-4.01], P < 0.001). Tryptase was an independent risk factor of MACE (HR 1.56 [1.29-1.88] per 1-unit increase, P < 0.001). Subgroup analysis revealed the prognostic value of tryptase among different age groups, left ventricular ejection levels, and patients with hypertension, hyperlipidemia, smoking and diabetes. The addition of tryptase to the basic model had an incremental effect on the predictive value for MACE (AUC: 0.763 vs 0.702, P = 0.002).

Conclusion: In this study, elevated tryptase levels, a biomarker of MC activation, were identified as a significant predictor of MACE in STEMI patients undergoing PPCI.

Trial registration: (ClinicalTrials.gov NCT05802667).

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胰蛋白酶作为st段抬高型心肌梗死患者不良预后的生物标志物：一项前瞻性队列研究

背景：急性st段抬高型心肌梗死（STEMI）以快速炎症反应为特征，肥大细胞（MCs）在其中起着重要作用。然而，MC激活与不良结果之间的关系尚不清楚。本研究调查了MC激活生物标志物、胰蛋白酶和主要不良心血管事件（MACE）之间的关系。方法：本前瞻性研究纳入了2020年7月至2023年7月在北京大学第三医院接受原发性经皮冠状动脉介入治疗（PPCI）的STEMI患者。采用ELISA法检测ppci后6 h血浆中胰蛋白酶水平。所有患者每6个月随访一次，以MACE为主要终点。结果：514例STEMI患者接受了PPCI（平均年龄：59.27±13.26岁，其中16.93%为女性）。中位随访时间为13.28（10.47 ~ 37.61）个月，其中85例（16.54%）发生MACE。高胰酶组患者发生MACE的风险较高（HR 2.60 [1.68-4.01], P < 0.001）。胰蛋白酶是MACE的独立危险因素（HR为1.56[1.29-1.88]/ 1单位，P < 0.001）。亚组分析显示胰蛋白酶在不同年龄组、左室射血水平、高血压、高脂血症、吸烟和糖尿病患者中的预后价值。在基本模型中添加胰蛋白酶对MACE的预测值有递增效应（AUC: 0.763 vs 0.702, P = 0.002）。结论：在这项研究中，胰蛋白酶水平升高（MC激活的生物标志物）被确定为STEMI患者PPCI中MACE的重要预测因子。试验注册：（ClinicalTrials.gov NCT05802667）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Inflammation Research Immunology and Microbiology-Immunology

CiteScore

6.10

自引率

2.20%

发文量

658

审稿时长

16 weeks

期刊介绍： An international, peer-reviewed, open access, online journal that welcomes laboratory and clinical findings on the molecular basis, cell biology and pharmacology of inflammation.