医学
内科学
心脏病学
狼牙棒
心肌梗塞
危险系数
比例危险模型
基里普班
心力衰竭
经皮冠状动脉介入治疗
置信区间
作者
Xiang Zhou,Jianchang Chen,Qing Zhang,Jing Shao,Kang Du,Xiaohua Xu,Yuan Kong
标识
DOI:10.1016/j.jacc.2016.02.035
摘要
Recent studies in animal models and humans have shown that corin is critically involved in the regulation of salt-water balance, blood pressure, and cardiac function.The goal of this study was to investigate the prognostic value of plasma soluble corin in patients with acute myocardial infarction (AMI).We enrolled 1,382 consecutive AMI patients in a prospective cohort study and explored the association of plasma corin with AMI outcomes using multivariable Cox proportional hazards analysis.Patients with low corin levels were more likely to be female and to have histories of hypertension and heart failure (HF). Kaplan-Meier survival curves indicated that patients with corin levels above the median had a lower incidence of major adverse cardiac events (MACE) and all-cause mortality compared with those whose corin levels were below the median. Multivariate Cox regression analysis suggested that log corin was an independent predictor of MACE (hazard ratio [HR]: 0.61; 95% confidence interval [CI]: 0.42 to 0.96; p = 0.029), together with age, previous histories of AMI, HF, and diabetes, Killip class, percutaneous coronary intervention, coronary artery bypass graft, beta-blocker use, and log N-terminal pro-B-type natriuretic peptide. The C-statistic and integrated discrimination improvement for MACE were improved significantly by the addition of corin to the reference model. Moreover, log corin was also found to be a significant predictor of death (HR: 0.65; 95% CI: 0.41 to 0.97; p = 0.036) and HF hospitalization (HR: 0.48; 95% CI: 0.23 to 0.90; p = 0.009) after adjustment for clinical variables and established biomarkers of adverse prognosis.Our study demonstrates that corin is a valuable prognostic marker of MACE in patients with AMI, independent of established conventional risk factors.
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