1
|
Mehrban A, Hajikolaei FA, Karimi M, Khademi R, Ansari A, Qujeq D, Hajian-Tilaki K, Monadi M. Evaluation of elevated serum apelin-13 and D-dimer concentrations in individuals diagnosed with pulmonary embolism. Int J Emerg Med 2024; 17:48. [PMID: 38565984 PMCID: PMC10986010 DOI: 10.1186/s12245-024-00619-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/17/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Given the limited specificity of D-dimer, there is a perceived need to discover a more precise marker for diagnosing individuals who are suspected of having pulmonary embolism (PE). In this study, by evaluating the increase in the serum level of Apelin-13 and D-dimer, we found valuable findings about Apelin-13, which can be suggested as an auxiliary and non-invasive diagnostic biomarker in individuals with suspected PE, based on the obtained results. METHODS In this case-control study, 52 Iranian individuals were included, all of whom were suspected to have PE. These individuals were then divided into two groups based on the results of CT angiography, which is considered the gold standard imaging method for diagnosing PE. The two groups were patients with PE and patients without PE. Finally, the levels of certain markers in the serum were compared between the two groups. RESULTS The mean serum D-dimer levels in patients with PE were significantly elevated (p < 0.001) in comparison to those without PE (1102.47 to 456.2 ng/ml). Furthermore, the mean level of Apelin-13 was significantly higher in patients with PE (49.8 to 73.11 ng/L) (p < 0.001). The cutoff point of Apelin-13 has been calculated at 58.50 ng/ml, with 90.9% sensitivity and 90% specificity. The D-dimer cutoff point was 500 ng/ml, with 95.5% sensitivity and 43.3% specificity. CONCLUSIONS Based on the results of this study, the serum level of Apelin-13 can be used as a novel diagnostic and screening biomarker in patients with pulmonary thromboembolism.
Collapse
Affiliation(s)
- Alireza Mehrban
- Shariati Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | | | - Mehdi Karimi
- Bogomolets National Medical University (NMU), Kyiv, Ukraine.
| | - Reza Khademi
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical (MUMS) , Mashhad, Iran
| | - Akram Ansari
- Shantou University Medical College, Shantou, Guangdong, China
| | - Durdi Qujeq
- Department of Clinical Biochemistry, Babol University of Medical Sciences (MUBabol), Babol, Iran
| | - Karimollah Hajian-Tilaki
- Department of Social Medicine, Faculty of Medicine, Babol University of Medical Sciences (MUBabol), Babol, Iran
| | - Mahmood Monadi
- Department of Internal Medicine, Babol University of Medical Sciences (MUBabol), Babol, Iran.
- School of Medicine, Babol University of Medical Sciences (MUBabol), Babol, Iran.
| |
Collapse
|
2
|
Peng R, Yin W, Wang F, Cong X, Lu B, Hua L, Chen X. Neutrophil levels upon admission for the assessment of acute pulmonary embolism with intermediate- and high-risk: an indicator of thrombosis and inflammation. Thromb J 2023; 21:28. [PMID: 36918857 PMCID: PMC10015714 DOI: 10.1186/s12959-023-00471-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 02/21/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Risk prediction rules are important to establish appropriate treatment and management strategy for patients with different risk classification of pulmonary embolism (PE). Neutrophils are considered to be related to PE as an essential marker of inflammation. However, few studies have reported the association between neutrophil levels and risk classification of acute PE (APE). The aim of this study was to investigate the role of neutrophil levels upon admission in the assessment of risk classification of APE. METHODS A total of 299 consecutive APE patients and 90 patients without APE confirmed by computed tomographic pulmonary angiography were retrospectively screened. APE patients were stratified into two subgroups according to clinical guidelines: low- (n = 233) and intermediate- and high-risk (n = 60) APE. RESULTS The neutrophil levels in intermediate- and high-risk APE patients were significantly higher compared to low-risk APE or non-APE patients (P < 0.001). In multivariable logistic regression analysis, neutrophil levels were significantly and independently associated with intermediate- and high-risk APE (odds ratio = 1.239, 95% confidence interval [CI] 1.055-1.455, P = 0.009). Neutrophil levels were positively correlated with the pulmonary embolism severity index score (r = 0.357, P < 0.001), high sensitive C-reactive protein, D-dimer and pulmonary artery obstruction index (PAOI), in the overall population of APE patients. Receiver-operating characteristic curve analysis revealed that neutrophils had a better diagnostic value for intermediate- and high-risk APE (area under the curve [AUC] = 0.760, 95% CI 0.695-0.826; P < 0.001) compared to PAOI (AUC = 0.719) and D-dimer (AUC = 0.645). CONCLUSIONS High neutrophil levels upon admission were significantly and independently associated with intermediate- and high-risk APE, which could be regarded as an indicator of inflammation and thrombosis in APE simultaneously. The potent diagnostic role of neutrophil levels and their competitive advantage over PAOI and D-dimer for the assessment of APE risk classification are suggested.
Collapse
Affiliation(s)
- Rui Peng
- Center of Clinical Laboratory, Beijing Friendship Hospital, Capital Medical University, Beijing, China.,Diagnostic Laboratory Service, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Weihua Yin
- Department of Radiology, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fang Wang
- Diagnostic Laboratory Service, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiangfeng Cong
- Diagnostic Laboratory Service, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bin Lu
- Department of Radiology, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lu Hua
- Key Laboratory of Pulmonary Vascular Medicine & State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Xi Chen
- Diagnostic Laboratory Service, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| |
Collapse
|
3
|
Zhang L, Jiang J, Li J, Wang M, Zhou J. Prognostic value of D-dimer to fibrinogen ratio for patients with acute myocardial infarction. EUR J INFLAMM 2022. [DOI: 10.1177/1721727x221132381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Objective Myocardial infarction is a severe disease with high in-hospital mortality without aggressive clinical treatment. The study aims to evaluate prognostic worth of D-dimer-to-fibrinogen (FIB) ratio (DFR) for patients with acute myocardial infarction (AMI). Methods 133 patients (65 (37, 93) years old) from our hospital (China) with AMI were enlisted from January 2017 to December 2019. Patients were assigned into the survivor and nonsurvivor group based on in-hospital outcomes. Receiver operating characteristics (ROC) and multivariate analysis were fulfilled to analyze the prognostic value of DFR. Results The degree of DFR in the nonsurvivor group was significantly higher than that in the survivor group ( p < 0.05). Logistic regression analysis presented that DFR (hazard ratio (HR), 2.207; 95% confidence interval (CI), 1.050–4.640; p = 0.037) was independently related with in-hospital death. ROC demonstrated that the area under the curve (AUC) of DFR was = 0.808 (0.725–0.892) (sensitivity, 85.3%; specificity, 69.7%). Conclusion DFR might be a new independent predictor of in-hospital death for AMI patients. Further studies are needed to validate this preliminary finding.
Collapse
Affiliation(s)
- Litao Zhang
- Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, China
- Branch of National Clinical Research Center for Laboratory Medicine, China
| | - Jiahong Jiang
- Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, China
- Branch of National Clinical Research Center for Laboratory Medicine, China
| | - Jie Li
- Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, China
- Branch of National Clinical Research Center for Laboratory Medicine, China
| | - Min Wang
- Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, China
- Branch of National Clinical Research Center for Laboratory Medicine, China
| | - Jun Zhou
- Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, China
- Branch of National Clinical Research Center for Laboratory Medicine, China
| |
Collapse
|
4
|
Lichter Y, Badelbayov T, Shalev I, Schvartz R, Szekely Y, Benisty D, Goldiner I, Kagarlyk M, Asraf K, Doolman R, Luttwak E, Kirgner I, Avivi I, Adi N, Katz BZ. Low FXIII activity levels in intensive care unit hospitalized COVID-19 patients. Thromb J 2021; 19:79. [PMID: 34736472 PMCID: PMC8567130 DOI: 10.1186/s12959-021-00333-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 10/17/2021] [Indexed: 12/26/2022] Open
Abstract
Background COVID-19 infection is associated with a hypercoagulable state. Severe COVID-19 patients present with high plasma fibrinogen levels, continuous deposition of fibrin and the presence of microthrombi in their lungs, accompanied by significant fibrinolysis, resulting in high D-dimer levels. Due to the role of FXIII in fibrin crosslinking and clot stabilization, we analyzed its activity levels and dynamics in COVID-19 patients hospitalized in the intensive care unit (ICU). Methods FXIII levels were measured in thirty four COVID-19 patients hospitalized in the ICU and in fourteen non-severe COVID-19 patients. FVIII levels were measured for comparison. Laboratory data and clinical variables were recorded. Results The average FXIII activity level in 34 ICU hospitalized COVID-19 patients was 69.9±33 %, significantly lower compared to an average of 120±20.9 % FXIII activity in 14 non-severe COVID-19 patients. FXIII activity levels were below the low normal value (< 79 % FXIII activity) in 74 % of the ICU hospitalized COVID-19 patients. In contrast, high FVIII activity was measured among all severe COVID-19 patients. Consecutive measurements, performed in fourteen ICU hospitalized COVID-19 patients, pointed to a significant decrease in FXIII activity from the average of 85.7±28.2 %, (which is in the normal range), to an average of 68.0±20.4 %, below the low normal range, within 6.4±3.4 days of ICU hospitalization. Liver functions did not differentiate between patients with low and normal FXIII activity. No inhibitor to FXIII activity was found in the plasma of severe COVID-19 patients. Levels of FXIII-A antigen correlated with FXIII activity, and were low in severe COVID-19 patients. Conclusions Low FXIII activity levels were found in COVID-19 patients hospitalized in the ICU, with gradual decline during their hospitalization. A mechanism of consumption may account for the low FXIII activity in these patients.
Collapse
Affiliation(s)
- Yael Lichter
- The Intensive Care Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Tanya Badelbayov
- The Hematology Institute, Tel Aviv Sourasky Medical Center, 6 Weizman St, Tel Aviv, Israel
| | - Irina Shalev
- The Hematology Institute, Tel Aviv Sourasky Medical Center, 6 Weizman St, Tel Aviv, Israel
| | - Reut Schvartz
- Division of anesthesiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Yishay Szekely
- The Division of cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Dan Benisty
- The Hematology Institute, Tel Aviv Sourasky Medical Center, 6 Weizman St, Tel Aviv, Israel
| | - Ilana Goldiner
- The Central Laboratory, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Maxim Kagarlyk
- The Dworman Automated-Mega Laboratory, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Keren Asraf
- The Dworman Automated-Mega Laboratory, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Ram Doolman
- The Dworman Automated-Mega Laboratory, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
| | - Efrat Luttwak
- The Hematology Institute, Tel Aviv Sourasky Medical Center, 6 Weizman St, Tel Aviv, Israel
| | - Ilya Kirgner
- The Hematology Institute, Tel Aviv Sourasky Medical Center, 6 Weizman St, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Irit Avivi
- The Hematology Institute, Tel Aviv Sourasky Medical Center, 6 Weizman St, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nimrod Adi
- The Intensive Care Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ben-Zion Katz
- The Hematology Institute, Tel Aviv Sourasky Medical Center, 6 Weizman St, Tel Aviv, Israel. .,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| |
Collapse
|
5
|
The plasma D-dimer trends and their value in acute lower limb ischemia patients treated by catheter directed thrombolysis. Sci Rep 2021; 11:10388. [PMID: 34001969 PMCID: PMC8128900 DOI: 10.1038/s41598-021-89905-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 05/04/2021] [Indexed: 11/20/2022] Open
Abstract
To investigate the change trends of plasma D-dimer during catheter-directed thrombolysis (CDT) in acute lower limb ischemia (ALI) patients and their clinical value. A retrospective review of patients with ALI who received CDT was carried out. The repeated measurements of plasma D-dimer were analyzed by generalized estimating equations (GEEs) and the change trends of D-dimer were analyzed by spline regression approach. A total of 150 patients were included. Among them, 3 days of CDT was ineffective in 41 cases, effective in 33 cases and markedly effective in 76 cases. The results of GEEs analysis showed that serum D-dimer changed significantly with time (time effect, P < 0.001). Serum D-dimer levels of patients with different treatment outcomes were different after treatment (group effect, P < 0.001), and serum D-dimer levels in these three groups showed different trends over time (group*time effect, P < 0.001). The different trends in serum D-dimer level with time after treatment in the three groups could be directly seen in the spline regression curve (P < 0.001). The plasma D-dimer changes regularly during CDT for ALI. We can predict the efficacy of CDT and guide adjustments of the therapeutic regimen according to the trend of D-dimer changes during thrombolysis.
Collapse
|
6
|
Nakamura K, Orii K, Hanai M, Abe T, Haida H. Management of acute pulmonary embolism after acute aortic dissection surgery. J Cardiol Cases 2020; 22:195-197. [PMID: 33014204 PMCID: PMC7520534 DOI: 10.1016/j.jccase.2020.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 06/03/2020] [Accepted: 06/08/2020] [Indexed: 11/24/2022] Open
Abstract
Acute aortic dissection (AAD) continues to be associated with high mortality and morbidity. Pulmonary embolism is also a life-threatening disease. The treatment of these life-threatening diseases remains controversial in case complications arise. Thrombolytic therapy and intensive treatment would be needed to manage these fatal diseases. A 49-year-old man with progressive back pain was admitted to our hospital. Computed tomography (CT) scan revealed type A AAD. Emergency operation for hemiarch replacement was performed. Two weeks postoperatively, the patient’s oxygenation worsened and his d-dimer levels elevated. CT scan revealed a massive thrombus in the bilateral pulmonary arteries. Intensive anticoagulation therapy was started immediately. On postoperative day 27, the patient was weaned from mechanical ventilation, but the false lumen with thrombus was recanalized again. The patient was discharged on postoperative day 75 without resulting in major complications for aortic dissection. The diagnosis of pulmonary embolism concomitant with AAD is difficult. The treatment of pulmonary embolism after AAD is controversial. Our strategy seems to be suitable for acute pulmonary embolism that occurs during the treatment of AAD. ˂Learning objective: The diagnosis of pulmonary embolism concomitant with acute aortic dissection (AAD) is difficult. The treatment of pulmonary embolism after AAD is controversial. Investigating factor XIII levels might help in the early detection of pulmonary embolism.>
Collapse
Affiliation(s)
- Ken Nakamura
- Department of Cardiac Surgery, Saitama Cardiovascular and Respiratory Center, Kumagaya-shi, Saitama, Japan
| | - Kouan Orii
- Department of Cardiac Surgery, Saitama Cardiovascular and Respiratory Center, Kumagaya-shi, Saitama, Japan
| | - Makoto Hanai
- Department of Cardiac Surgery, Saitama Cardiovascular and Respiratory Center, Kumagaya-shi, Saitama, Japan
| | - Takayuki Abe
- Department of Cardiac Surgery, Saitama Cardiovascular and Respiratory Center, Kumagaya-shi, Saitama, Japan
| | - Hirofumi Haida
- Department of Cardiac Surgery, Saitama Cardiovascular and Respiratory Center, Kumagaya-shi, Saitama, Japan
| |
Collapse
|
7
|
Wang M, Fu Y, Xu L, Xiao L, Yue Y, Liu S, Huang Q, Li S, Li Y. Diagnostic value of platelet-derived microparticles in pulmonary thromboembolism: A population-based study. Exp Ther Med 2018; 16:3099-3106. [PMID: 30233670 DOI: 10.3892/etm.2018.6579] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 07/25/2018] [Indexed: 01/25/2023] Open
Abstract
An early and accurate diagnosis of pulmonary thromboembolism (PTE) remains challenging. The present study aimed to evaluate the diagnostic value of platelet-derived microparticles in PTE based on a population study. A total of 102 patients with PTE, 102 healthy controls and 40 patients suspected with PTE were enrolled in this study. The platelet count, mean platelet volume and platelet distribution width were assessed using an automated hematology analyzer, P-selectin was assessed using an ELISA kit and PMPs were explored using flow cytometry using Megamix beads. Receiver operating characteristic curves were established to evaluate the diagnostic values of PMPs, D-dimer, PMPs combined with D-dimer, and multiple parameters (including PMPs, platelet distribution width, P-selectin and D-dimer in PTE). The PMP levels were significantly higher in the patients with PTE (609.10/µl) compared with those in the healthy controls (230.60/µl) and patients with suspicious PTE (166.70/µl; P<0.01). The accuracy (72.06%) of PMPs in the diagnosis of PTE was similar to those of D-dimer (P>0.05). The combination of D-dimer and PMPs significantly increased the sensitivity (86.27%) of D-dimer and the specificity of PMP for the diagnosis of PTE (P<0.01). The combination of PMPs, platelet distribution width, P-selectin and D-dimer exhibited high sensitivity (88.24%), specificity (91.18%) and accuracy (89.71%) in the diagnosis of PTE. These findings suggest that elevated PMP levels are an effective predictor of PTE. The combination of PMPs, platelet distribution width, P-selectin and D-dimer may be used in the diagnosis of PTE with high sensitivity and specificity.
Collapse
Affiliation(s)
- Minglian Wang
- Department of Respiratory and Critical Care Medicine, The Second Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong 518020, P.R. China.,Shenzhen Key Laboratory of Respiratory Disease, The Second Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong 518020, P.R. China
| | - Yingyun Fu
- Department of Respiratory and Critical Care Medicine, The Second Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong 518020, P.R. China.,Shenzhen Key Laboratory of Respiratory Disease, The Second Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong 518020, P.R. China
| | - Lan Xu
- Department of Respiratory and Critical Care Medicine, The Second Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong 518020, P.R. China
| | - Lu Xiao
- Department of Respiratory and Critical Care Medicine, The Second Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong 518020, P.R. China
| | - Yongjian Yue
- Department of Respiratory and Critical Care Medicine, The Second Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong 518020, P.R. China.,Shenzhen Key Laboratory of Respiratory Disease, The Second Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong 518020, P.R. China
| | - Shengguo Liu
- Department of Respiratory and Critical Care Medicine, The Second Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong 518020, P.R. China
| | - Qijun Huang
- Department of Respiratory and Critical Care Medicine, The Second Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong 518020, P.R. China
| | - Shulin Li
- Department of Respiratory and Critical Care Medicine, The Second Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong 518020, P.R. China
| | - Yazhen Li
- Department of Respiratory and Critical Care Medicine, The Second Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong 518020, P.R. China.,Shenzhen Key Laboratory of Respiratory Disease, The Second Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong 518020, P.R. China
| |
Collapse
|
8
|
In primary glioblastoma fewer tumor copy number segments of the F13A1 gene are associated with poorer survival. Thromb Res 2018; 167:12-14. [PMID: 29753279 DOI: 10.1016/j.thromres.2018.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/06/2018] [Accepted: 05/03/2018] [Indexed: 11/21/2022]
|
9
|
Feng WZ, Zhou JQ, Yu GM, Zeng Y, Xu P. Association of serum cystatin C levels with mortality in patients with acute type A aortic dissection. Oncotarget 2017; 8:101103-101111. [PMID: 29254149 PMCID: PMC5731859 DOI: 10.18632/oncotarget.20593] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 07/26/2017] [Indexed: 12/31/2022] Open
Abstract
Increased serum cystatin C levels are related to the prognosis of cardiovascular diseases. This study aims to investigate the effect of admission serum cystatin C levels on short- and long-term mortality in patients with acute type A aortic dissection (ATAAD). From 2010 to 2014, 136 consecutive patients with ATAAD were enrolled and followed up. Clinical data and laboratory assays including were measured. During a median follow-up of 198.7 days, the short-term mortality (30-days) was 20.6%, whereas the long-term death rate was 10.2%. We identified that the expression of cystatin C and high-sensitivity C-reactive protein (hs-CRP) in the dying patients was higher than in the surviving patients (P < 0.01). Hs-CRP (HR = 1.41, 95% CI: 1.03–2.59, P = 0.037) was an independent risk factor of short-term death determined by univariate and multivariate Cox analyses. No impact of cystatin C was observed on the short-term mortality. For long-term mortality, cystatin C (HR = 1.49, 95% CI: 1.10–7.36, P = 0.013) was identified as an independent predictor at above the cut-off value ≥ 1.10 mg/L. ROC analysis showed the AUC values of cystatin C and hs-CRP were 0.772 (95% CI, 0.692–0.839) and 0.640 (95% CI, 0.574–0.739), respectively, in the prediction of long-term death. The combined AUC value of cystatin C and hs-CRP was 0.883 (95% CI, 0.826–0.935; P < 0.01). Taken together, high cystatin C levels (≥ 1.10 mg/L) on admission are independently associated with the long-term mortality in patients with ATAAD.
Collapse
Affiliation(s)
- Wei-Zhong Feng
- Department of Cardiothoracic Surgery, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing 312000, Zhejiang Province, China
| | - Jun-Qing Zhou
- Department of Cardiothoracic Surgery, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing 312000, Zhejiang Province, China
| | - Guang-Mao Yu
- Department of Cardiothoracic Surgery, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing 312000, Zhejiang Province, China
| | - Yong Zeng
- Department of Cardiothoracic Surgery, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing 312000, Zhejiang Province, China
| | - Peng Xu
- Department of Cardiothoracic Surgery, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing 312000, Zhejiang Province, China
| |
Collapse
|