title: Role of stromal cell-derived factor-1 in patients with non-ST elevation acute coronary syndrome.
abstract: The predictive value of stromal cell-derived factor-1 (SDF-1) has not been established in patients with non-ST elevation acute coronary syndrome (non-STEACS). A total of 678 consecutive patients with non-STEACS and moderate to high TIMI (Thrombolysis In Myocardial Infarction) risk scores were recruited. All patients underwent an early invasive strategy and then were followed-up for 18 months for clinical events. Left ventricular remodeling was assessed by echocardiography. Plasma concentrations of SDF-1 and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were analyzed. SDF-1 level was an independent predictor of left ventricular remodeling (OR = 2.95, 95% CI = 2.02-4.30, P < 0.001). Cox regression analysis demonstrated that both SDF-1 and NT-proBNP levels were significant independent predictors of death, myocardial infarction, or heart failure (HR = 2.45, 95% CI = 1.71-3.50, P < 0.001; HR = 3.71, 95% CI = 2.41-5.70, P < 0.001, respectively). The area under the ROC curves for SDF-1 (0.776) and NT-proBNP (0.817) were similar. The logistic model with both markers yielded a larger area under the ROC curve (0.862) than that of SDF-1 (P < 0.001) or NT-proBNP (P = 0.0001) alone. In patients stratified by NT-proBNP (above 615.4 pmol/L), SDF-1 (above 2175.1 pg/mL) was associated with poorer outcome (P < 0.001). Findings were similar for death and heart failure as individual endpoints. In non-STEACS, higher SDF-1 levels were a significant predictor of death, myocardial infarction, or heart failure independently of baseline clinical characteristics and NT-proBNP, and the combination of SDF-1 and NTproBNP significantly improved risk stratification. These data highlight the prognostic value of multiple, complementary biomarkers in non-ST elevation acute coronary syndrome.
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University.
authors.forename: Guoxin
authors.initials: G
authors.lastname: Tong
authors.forename: Ningfu
authors.initials: N
authors.lastname: Wang
authors.forename: Yujie
authors.initials: Y
authors.lastname: Zhou
authors.forename: Jianhang
authors.initials: J
authors.lastname: Leng
authors.forename: Wei
authors.initials: W
authors.lastname: Gao
authors.forename: Xiaoshan
authors.initials: X
authors.lastname: Tong
authors.forename: Yun
authors.initials: Y
authors.lastname: Shen
authors.forename: Jianmin
authors.initials: J
authors.lastname: Yang
authors.forename: Xianhua
authors.initials: X
authors.lastname: Ye
authors.forename: Liang
authors.initials: L
authors.lastname: Zhou
authors.forename: Yan
authors.initials: Y
authors.lastname: Gao
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology; D000368:Aged; D015415:Biomarkers / Q000097:blood; D054377:Chemokine CXCL12 / Q000097:blood*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D020257:Ventricular Remodeling
chemical_list: D015415:Biomarkers; D054377:Chemokine CXCL12