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首页> 外文期刊>Translational research: the journal of laboratory and clinical medicine >Circulating fibrocytes as predictors of adverse events in unstable angina
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Circulating fibrocytes as predictors of adverse events in unstable angina

机译：循环纤维细胞可预测不稳定型心绞痛不良反应

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Half of the patients who present with unstable angina (UA) develop recurrent symptoms over the subsequent year. Identification of patients destined to develop such adverse events would be clinically valuable, but current tools do not allow for this discrimination. Fibrocytes are bone marrow-derived progenitor cells that co-express markers of leukocytes and fibroblasts and are released into the circulation in the context of tissue injury. We hypothesized that, in patients with UA, the number of circulating fibrocytes predicts subsequent adverse events. We enrolled 55 subjects with UA, 18 with chronic stable angina, and 22 controls and correlated their concentration of circulating fibrocytes to clinical events (recurrent angina, myocardial infarction, revascularization, or death) over the subsequent year. Subjects with UA had a >2-fold higher median concentration of both total and activated fibrocytes compared with subjects with chronic stable angina and controls. In UA subjects, the concentration of total fibrocytes identified those who developed recurrent angina requiring revascularization (time-dependent area under the curve 0.85) and was superior to risk stratification using thrombolysis in myocardial infarction risk score and N-terminal pro B-type natriuretic peptide levels (area under the curve, 0.53 and 0.56, respectively, P < 0.001). After multivariable adjustment for thrombolysis in myocardial infarction predicted death, MI, or recurrent ischemia, total fibrocyte level was associated with recurrent angina (hazard ratio, 1.016 per 10,000 cells/mL increase; 95% confidence interval, 1.007-1.024; P < 0.001). Circulating fibrocytes are elevated in patients with UA and successfully risk stratify them for adverse clinical outcomes. Fibrocytes may represent a novel biomarker of outcome in this population.
机译：表现为不稳定型心绞痛（UA）的患者中有一半在接下来的一年中出现复发症状。确定将要发展为此类不良事件的患者具有临床价值，但是当前的工具不允许这种区分。纤维细胞是骨髓来源的祖细胞，它们共同表达白细胞和成纤维细胞的标志物，并在组织损伤的情况下释放到循环系统中。我们假设，在患有UA的患者中，循环纤维细胞的数量预示了随后的不良事件。我们招募了55名UA受试者，18名慢性稳定型心绞痛和22名对照，并将其循环纤维细胞的浓度与随后一年的临床事件（复发性心绞痛，心肌梗塞，血运重建或死亡）相关。与患有慢性稳定型心绞痛和对照组的受试者相比，患有UA的受试者的总和活化纤维细胞的中值浓度高2倍以上。在UA受试者中，总纤维细胞的浓度确定了那些需要进行血管重建的复发性心绞痛的患者（曲线下随时间变化的区域0.85），并优于使用溶栓治疗的心肌梗塞风险评分和N端前B型利尿钠肽的风险分层水平（曲线下面积分别为0.53和0.56，P <0.001）。在对心肌梗死的溶栓进行了多变量调整后，预测死亡，MI或复发性缺血，总纤维细胞水平与复发性心绞痛相关（危险比，每10,000个细胞/ mL增加1.016; 95％置信区间，1.007-1.024; P <0.001） 。 UA患者的循环纤维细胞升高，并成功将其分层以产生不利的临床结果。纤维细胞可能代表该人群中结局的新生物标志物。

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