High levels of stromal cell-derived factor-1α predict secondary cardiac events in stable patients with a history of myocardial infarction

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• 作者：Satoshi Matsuoka ; MD ; Manabu Uematsu ; MD ; Takamitsu Nakamura ; MD ; PhD ; Takuya Shimizu ; MD ; Mika Futamata ; MD ; Jun-ei Obata ; MD ; PhD ; Daisuke Fujioka ; MD ; PhD ; Kazuto Nakamura ; MD ; PhD ; Toru Yoshizaki ; MD ; Kiyotaka Kugiyama ; MD ; PhD ; FJCC ; ^{kugiyama@yamanashi.ac.jp}
• 关键词：Stromal cell-derived factor-1α ; Myocardial infarction ; Prognosis ; Cardiac events ; Inflammatory marker
• 刊名：Journal of Cardiology
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：69
• 期：1
• 页码：320-325
• 全文大小：476 K
• 卷排序：69

文摘

We recently showed that stromal cell-derived factor (SDF)-1α, a pro-inflammatory mediator, is produced in infarcted myocardium and is associated with left ventricular (LV) adverse remodeling and progressive dysfunction following acute myocardial infarction (AMI). The current study examined whether SDF-1α levels in the peripheral vein can provide prognostic information of outcomes in stable patients with a history of MI.MethodsPlasma levels of SDF-1α in the peripheral vein were measured by enzyme-linked immunosorbent assay in 192 stable patients with a history of MI. All patients were followed prospectively for a period of 90 months or until occurrence of one of the following cardiac events: cardiac death, non-fatal myocardial infarction, unstable angina requiring unplanned coronary revascularization, or worsening heart failure requiring hospital admission.ResultsDuring the follow-up period (77 ± 26 months), 30 patients had cardiac events. Multivariate Cox analysis revealed that high levels of SDF-1α (≥2162 pg/mL; a cut-off value determined by receiver-operating characteristic analysis) were a significant predictor of cardiac events, independent of traditional risk factors (HR: 1.98; 95% CI: 1.38–2.85; p < 0.001). The addition of high levels of SDF-1α to conventional risk factors including brain natriuretic peptide improved net reclassification improvement (NRI) and integrated discrimination improvement (IDI) (NRI 0.90, p < 0.0001; and IDI 0.05, p = 0.002).ConclusionsHigh levels of SDF-1α predicted secondary cardiac events in stable patients with a history of MI. SDF-1α levels may be a useful risk assessment tool in patients with a history of MI.