α1-Antichymotrypsin Complex (SERPINA3) Is an Independent Predictor of All-Cause but Not Cardiovascular Mortality in Patients Hospitalized for Chest Pain of Suspected Coronary Origin

被引:1
作者
Nilsen, Dennis Winston T. [1 ,2 ]
Aarsetoey, Reidun [1 ]
Poenitz, Volker [1 ]
Ueland, Thor [3 ]
Aukrust, Pal [4 ,5 ,6 ]
Michelsen, Annika Elisabet [4 ,5 ]
Brugger-Andersen, Trygve [7 ]
Staines, Harry [8 ]
Grundt, Heidi [1 ,9 ]
机构
[1] Stavanger Univ Hosp, Dept Cardiol, Stavanger, Norway
[2] Univ Bergen, Dept Clin Sci, Bergen, Norway
[3] UiT The Arctic Univ Norway, Thrombosis Res Ctr, Dept Clin Med, Tromso, Norway
[4] Univ Oslo, Fac Med, Oslo, Norway
[5] Oslo Univ Hosp, Res Inst Internal Med, Rikshosp, Oslo, Norway
[6] Oslo Univ Hosp, Sect Clin Immunol & Infect Dis, Rikshosp, Oslo, Norway
[7] Stavanger Heart Ctr, Stavanger, Norway
[8] Sigma Stat Serv, Balmullo, England
[9] Stavanger Univ Hosp, Dept Resp Med, Stavanger, Norway
关键词
alpha 1-antichymotrypsin complex (SERPINA3); Biomarkers; Acute coronary syndrome; Cardiovascular disease events; Mortality; CARDIAC TROPONIN-T; ELISA;
D O I
10.1159/000537919
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction: SERPINA3 is an acute-phase protein triggered by inflammation. It is upregulated after an acute myocardial infarction (AMI). Data on its long-term prognostic value in MI patients are scarce. We aimed to assess the utility of SERPINA3 as a prognostic marker in patients hospitalized for chest pain of suspected coronary origin. Methods: A total of 871 consecutive patients, 386 diagnosed with AMI, were included. Stepwise Cox regression models, applying continuous log(e)-transformed values, were fitted for the biomarker with all-cause mortality and cardiac death within 2 years or all-cause mortality within the median 7 years as dependent variables. An analysis of MI and stroke, and combined endpoints, respectively, was added. The hazard ratio (HR) (95% CI) was assessed in a univariate and multivariable model. Results: Plasma samples from 847 patients were available. By 2-year follow-up, 138 (15.8%) patients had died, of which 86 were cardiac deaths. The univariate analysis showed a significant association between SERPINA3 and all-cause mortality (HR 1.41 [95% 1.19-1.68], p < 0.001) but not for cardiac death. Associations after adjustment were non-significant. By 7-year follow-up, 332 (38.1%) patients had died. SERPINA3 was independently associated with all-cause mortality from the third year onward. The HR was 1.14 (95% CI, 1.02-1.28), p = 0.022. Similar results applied to combined endpoints, but not for MI and stroke, respectively. The prognostic value of SERPINA3 was limited to non-AMI patients. No independent associations were noted among AMI patients. Conclusions: SERPINA3 predicts long-term all-cause mortality but fails to predict outcome in AMI patients.
引用
收藏
页码:338 / 346
页数:9
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