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首页> 外文期刊>Medicine. >The Kinetics of Circulating Monocyte Subsets and Monocyte-Platelet Aggregates in the Acute Phase of ST-Elevation Myocardial Infarction: Associations with 2-Year Cardiovascular Events
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The Kinetics of Circulating Monocyte Subsets and Monocyte-Platelet Aggregates in the Acute Phase of ST-Elevation Myocardial Infarction: Associations with 2-Year Cardiovascular Events

机译：ST抬高型心肌梗死急性期循环单核细胞亚群和单核细胞-血小板聚集的动力学：与2年心血管事件的关联。

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In experimental myocardial infarction (MI), a rise in cell counts of circulating monocyte subsets contributes to impaired myocardial healing and to atherosclerotic plaque destabilization. In humans, the prognostic role of monocyte subsets in patients suffering ST-elevation MI (STEMI) is still unclear. In the present study, we aimed to determine the kinetics of the 3 monocyte subsets (classical CD14++CD16–, intermediate CD14++CD16+, and nonclassical CD14+CD16++ monocytes), as well as the subset-specific monocyte–platelet aggregates (MPA), in acute STEMI followed by primary percutaneous coronary intervention (PCI), and their relationships with cardiovascular outcomes during a 2-year follow-up. Monocyte subsets and MPA were measured in 100 STEMI patients receiving primary PCI on days 1, 2, 3, 5, and 7 of symptom onset, which were compared with 60 stable coronary heart disease patients and 35 healthy volunteers. From day 1 to day 7, significant increases in the counts of CD14++CD16+ monocytes and CD14++CD16+ MPA were observed, with peak levels on day 2. During a median follow-up of 2.0 years, 28 first cardiovascular events (defined as cardiovascular death, nonfatal ischemic stroke, recurrent MI, need for emergency or repeat revascularization, and rehospitalization for heart failure) were recorded. After adjustment for confounders, CD14++CD16+ monocytosis (day 1 [HR: 3.428; 95% CI: 1.597–7.358; P?=?0.002], day 2 [HR: 4.835; 95% CI: 1.106–21.13; P?=?0.04], day 3 [HR: 2.734; 95% CI: 1.138–6.564; P?=?0.02], and day 7 [HR: 2.647; 95% CI: 1.196–5.861; P?=?0.02]), as well as increased levels of CD14++CD16+ MPA measured on all time points (days 1, 2, 3, 5, and 7), had predictive values for adverse cardiovascular events. In conclusion, our data show the expansion of the CD14++CD16+ monocyte subset during acute phase of STEMI has predictive values for 2-year adverse cardiovascular outcomes in patients treated with primary PCI. Future studies will be warranted to elucidate whether CD14++CD16+ monocytes may become a target cell population for new therapeutic strategies after STEMI.
机译：在实验性心肌梗塞（MI）中，循环单核细胞亚群的细胞计数增加会导致心肌愈合受损和动脉粥样硬化斑块失稳。在人类中，尚不清楚单核细胞亚群在患有ST抬高MI（STEMI）的患者中的预后作用。在本研究中，我们旨在确定3个单核细胞亚群（经典CD14 ++ CD16–，中间CD14 ++ CD16 +和非经典CD14 + CD16 ++单核细胞）的动力学，以及特定于子集的单核细胞-血小板聚集体（ （MPA），急性STEMI继之以原发性经皮冠状动脉介入治疗（PCI），以及在两年的随访中它们与心血管预后的关系。在100例症状发作的第1、2、3、5和7天接受初诊PCI的STEMI患者中测量了单核细胞亚群和MPA，并与60例稳定的冠心病患者和35名健康志愿者进行了比较。从第1天到第7天，观察到CD14 ++ CD16 +单核细胞和CD14 ++ CD16 + MPA的计数显着增加，并在第2天达到峰值。在2.0年的中位随访期间，发生了28例首次心血管事件（定义为记录为心血管死亡，非致命性缺血性中风，MI复发，需要紧急或重复血运重建以及因心力衰竭而再次住院。调整混杂因素后，CD14 ++ CD16 +单核细胞增多（第1天[HR：3.428; 95％CI：1.597-7.358; P <= 0.002]，第2天[HR：4.835; 95％CI：1.16-21.13; P？ =？0.04]，第3天[HR：2.734; 95％CI：1.138-6.564; P？=？0.02]，以及第7天[HR：2.647; 95％CI：1.196-5.861; P？=？0.02]） ，以及在所有时间点（第1、2、3、5和7天）测得的CD14 ++ CD16 + MPA含量升高，对心血管不良事件具有预测价值。总之，我们的数据显示，在STEMI急性期，CD14 ++ CD16 +单核细胞亚群的扩展对于接受原发性PCI治疗的2年不良心血管预后具有预测价值。未来的研究将有必要阐明CD14 ++ CD16 +单核细胞是否可能成为STEMI后新治疗策略的靶细胞群。

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