Increased Rho kinase activity predicts worse cardiovascular outcome in ST-segment elevation myocardial infarction patients.
BACKGROUND
Few clinical studies have assessed Rho kinase (ROCK) in patients with dia-betes mellitus (DM) and ST-segment elevation myocardial infarction (STEMI). This study aimed to determine whether ROCK activity in circulating leukocytes is increased in STEMI patients with DM and whether ROCK activity predicts the onset of cardiovascular events.


METHODS
Blood samples were collected from 60 STEMI patients, divided into non-diabetes mellitus (NDM) and DM groups. Main outcome measures were all-cause mortality, readmission for acute coronary syndrome (ACS), congestive heart failure (CHF), or stroke from pres-entation to approximately 5 years (mean: 41.3 ± 19.6 months; range: 3-60 months).


RESULTS
Compared with the NDM group (n = 34), ROCK1 activity was greater in the DM group (n = 26) (33.14 ± 11.31 vs. 26.24 ± 11.06, p = 0.021), while ROCK2 activity was not different between the groups. There occurred 3 deaths, and 10 readmissions with ACS, 4 with CHF and 2 with stroke during the follow-up period. Patients with a high ROCK1 activity on admission had a 3-fold risk of cardiovascular events (RR 3.15, 95% CI 1.04-9.58) compared with those with low ROCK1 activity. Patients with history of stroke had almost a 4-fold risk of cardiovascular events (RR 3.74; 95% CI 1.02-13.80).


CONCLUSIONS
ROCK1 activity was increased in STEMI patients with DM, which suggests that ROCK1 activity may be a useful diagnostic and prognostic marker of cardiovascular events for these patients. ROCK1 activity might help identify a subset of STEMI patients at particularly high risk.
Xiaohui
X
Li
Xing
X
Wu
Hongwei
H
Li
Hui
H
Chen
Yongliang
Y
Wang
Weiping
W
Li
Xiaosong
X
Ding
Capital Medical University. hxfriend@163.com.
Xu
X
Hong
D015415:Biomarkers / Q000097:blood; D002423:Cause of Death / Q000639:trends; D002681:China / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000201:enzymology* / Q000401:mortality; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000175:diagnosis / Q000201:enzymology* / Q000401:mortality; D015996:Survival Rate / Q000639:trends; D054460:rho-Associated Kinases / Q000097:blood*
D015415:Biomarkers; D054460:rho-Associated Kinases
Rho kinase activity; ST-segment elevation myocardial infarction; circulating leukocytes; diabetes mellitus; insulin resistance