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外周循环线粒体DNA拷贝数与急性心肌梗死患者近期预后的相关性研究

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摘要:

目的 探讨急性心肌梗死患者外周循环线粒体DNA(mtDNA)拷贝数与近期预后的关系。
方法 选取2018年1月至2020年12月期间就诊于郑州市第七人民医院心内科的急性ST段抬高型心肌梗死
患者。采集治疗前静脉血5 ml,应用qPCR法检测外周循环mtDNA拷贝数,经皮冠状动脉介入术(PCI)
和其他相关后续治疗,随访30 d,记录严重心力衰竭、严重房室传导阻滞和室性心动过速/心室颤动的
发生。应用多因素COX回归分析评估外周循环mtDNA拷贝数与这些不良心血管事件发生之间的相关性。
结果 共253例急性心肌梗死患者纳入本研究。其中,27例患者未在外周循环中检测到mtDNA,被分入
“mtDNA阴性组”。226例外周循环mtDNA检测阳性的患者根据检测结果的中位数被分为“mtDNA高
水平组”和“mtDNA低水平组”。多因素COX回归分析显示,与拥有较低外周循环mtDNA拷贝数的患
者相比,外周循环mtDNA拷贝数较高的患者发生严重心力衰竭、严重房室传导阻滞和室性心动过速/心
室颤动的可能性更大(HR=1.984,95%CI:1.206~3.266,P=0.007;HR=1.936,95%CI:1.064~3.525,
P=0.031;HR=4.046,95%CI:1.343~12.192,P=0.013)。结论 外周循环mtDNA拷贝数与急性心肌梗死
近期内多种不良心血管事件的发生相关,较高的外周循环mtDNA拷贝数是急性心肌梗死近期预后不良的
重要提示。

Abstract:

Objective To discuss the relationship between copy number of mitochondrial DNA (mtDNA) in peripheral circulation and short-term prognosis in patients with acute myocardial infarction (AMI). Methods The patients with ST-segment elevation myocardial infarction (STEMI) were chosen from Department of Cardiology in the Seventh People’s Hospital of Zhengzhou City from Jan. 2018 to Dec. 2020. The venous blood sample (5 ml) was collected, and mtDNA copy number in peripheral circulation was detected by using quantitative polymerase chain reaction (qPCR). The patients were treated with percutaneous coronary intervention (PCI) and other related subsequent treatments. The occurrence of severe heart failure (HF), severe atrioventricular block (AVB), ventricular tachycardia/ventricular fibrillation (VT/VF) were recorded after patients were followed up for 30 d. The correlation between mtDNA copy number in peripheral circulation and major adverse cardiovascular events (MACE) were reviewed by using multi-factor COX regression analysis. Results There were totally 253 patients included in this study, and mtDNA was not detected in 27 patients who were divided into negative mtDNA group. The patients (n=226) with positive mtDNA were divided, according to the median of detecting results, into high-level mtDNA group and low-level mtDNA group. The results of multi-factor COX regression analysis showed that the incidence rates of severe HF (HR=1.984, 95%CI: 1.206~3.266, P=0.007), severe AVB (HR=1.936, 95%CI: 1.064~3.525, P=0.031) and VT/VF (HR=4.046, 95%CI: 1.343~12.192, P=0.013) were higher in high-level mtDNA group then those in low-level mtDNA group. Conclusion The copy number of mtDNA in peripheral circulation is correlated to shortterm occurrence of MACE in AMI patients, and higher mtDNA copy number is an important indicator for short-term poor prognosis in AMI patients.

基金项目:

2021年河南省科技发展计划(212300410305)

参考文献:

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