基于单核细胞的新型心血管风险生物标志物:与 QRISK3 的比较

Fatemah Almarri, Soundrie Padayachee, Alexander Kerr, Ashish S Patel, Albert Ferro
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引用次数: 0

摘要

目的:有症状的动脉粥样硬化性心血管疾病患者的循环单核细胞-血小板聚集(MPA)和 CD14+/CD16+ 单核细胞会升高。这项研究的目的是,与传统的心血管风险计算器 QRISK3 相比,研究它们在预测无症状受试者早期动脉粥样硬化中的作用:在伦敦盖伊医院和圣托马斯医院高血压门诊就诊的无症状患者以及通过广告招募的健康自愿者(39 人)均被纳入调查范围。对血液(30 mL)进行流式细胞术处理,测量单核细胞的 CD14 和 CD16 表达以及 CD14+CD42b+ MPA。利用这些测量结果,开发出一种称为单核细胞动脉粥样硬化风险评分(MARS)的新指标。所有受试者还接受了颈动脉超声血管造影术。QRISK3 和 MARS 均与颈动脉内膜中层厚度 (cIMT) 显著相关;但 MARS 的相关性(r2 = 0.8705,P < 0.0001)比 QRISK3 的相关性(r2 = 0.3012,P = 0.0025)更接近。ROC 分析显示,MARS 对 cIMT 确定的心血管高风险(C 指数 = 0.9273,P = 0.0001)和颈动脉斑块的存在(C 指数 = 0.9385,P = 0.0022)都有很高的预测性,而 QRISK3 则没有。结论在预测 cIMT 和颈动脉斑块疾病方面,MARS 似乎优于 QRISK3。这可能有助于更好地识别无症状者,使其受益于有针对性的成像检查和预防性疗法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A novel monocyte-based biomarker of cardiovascular risk: comparison with QRISK3
Objective: Circulating monocyte-platelet aggregates (MPA) and CD14+/CD16+ monocytes are elevated in symptomatic patients with atherosclerotic cardiovascular disease. The aim of this study was to investigate their utility in prediction of early atherosclerosis in asymptomatic subjects, in comparison to a traditional cardiovascular risk calculator, QRISK3. Approach and Results: Asymptomatic patients attending the hypertension clinic at Guy's & St Thomas' Hospitals, London, and healthy volunteer subjects recruited by advertisement, were enrolled (n = 39). Blood (30 mL) was processed for flow cytometry to measure CD14 and CD16 expression on monocytes, and CD14+CD42b+ MPA. Using these measurements, a novel index termed the Monocyte Atherosclerotic Risk Score (MARS) was developed. All subjects also underwent carotid artery ultrasonic angiography. Both QRISK3 and MARS correlated significantly with carotid intima-media thickness (cIMT); however, the correlation was much closer for MARS (r2 = 0.8705, P < 0.0001) than for QRISK3 (r2 = 0.3012, P = 0.0025). ROC analysis revealed MARS to be highly predictive both of cIMT-determined high cardiovascular risk (C-index = 0.9273, P = 0.0001) and presence of carotid plaque (C-index = 0.9385, P = 0.0022), whereas QRISK3 was not. Conclusion: MARS appears superior to QRISK3 in predicting both cIMT and carotid plaque disease. This may help to better identify asymptomatic individuals who would benefit from targeted imaging investigations and prophylactic therapies.
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