Prognostic Value of Plasma Intermedin Level in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome.
Intermedin (IMD), an autocrine/paracrine biologically active peptide, plays a critical role in maintaining vascular homeostasis. Recent research has shown that high plasma levels of IMD are associated with poor outcomes for patients with ST-segment elevation acute myocardial infarction. However, the prognostic utility of IMD levels in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) has not yet been investigated. We hypothesized that the level of plasma IMD would have prognostic value in patients with NSTE-ACS. Plasma IMD was determined by radioimmunoassay in 132 NSTE-ACS patients on admission to hospital and 132 sex- and age-matched healthy-control subjects. Major adverse cardiovascular events (MACEs), including death, heart failure, hospitalization, and acute myocardial infarction, were noted during follow-up. In total, 23 patients suffered MACEs during the follow-up period (mean 227 ± 118 days, range 2-421 days). Median IMD levels were higher in NSTE-ACS patients than control [320.0 (250.9/384.6) vs. 227.2 (179.7/286.9) pg/mL, P <0.001]. The area under the receiver-operating characteristic curve for IMD and N-terminal pro-B-type brain natriuretic peptide (NT-proBNP) did not significantly differ (0.73 and 0.79, both P <0.001, respectively; P = 0.946). ROC curve analysis revealed a cut-off value for IMD at 340.7 pg/mL. Cox regression analysis with cardiovascular risk variables and NT-proBNP showed that the risk of MACEs increased by a factor of 12.96 (95% CI, 3.26-49.42; P <0.001) with high IMD levels (at the cut-off value). IMD has potential as a prognostic biomarker for predicting MACEs in patients with NSTE-ACS.
From the Peking University Aerospace School of Clinical Medicine (PL, LS, BW), Peking University Health Science Center; Department of Cardiology (PL, YH, YZ, BW), Aerospace Central Hospital; Laboratory of Cardiovascular Bioactive Molecule (YQ), School of Basic Medical Sciences; Key Laboratory of Molecular Cardiovascular Science (YQ), Ministry of Education; and Department of Pathogen Biology (YQ), School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China.
Pengyang
P
Li
Lin
L
Shi
Yalei
Y
Han
Yuntao
Y
Zhao
Yongfen
Y
Qi
Bin
B
Wang
D054058:Acute Coronary Syndrome / Q000097:blood* / Q000503:physiopathology; D000368:Aged; D015415:Biomarkers / Q000097:blood; D018450:Disease Progression; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D036361:Peptide Hormones / Q000097:blood*; D011379:Prognosis; D011863:Radioimmunoassay; D018570:Risk Assessment; D012307:Risk Factors
C484330:ADM2 protein, human; D015415:Biomarkers; D036361:Peptide Hormones