title: Altered gene expression in T-cell receptor signalling in peripheral blood leucocytes in acute coronary syndrome predicts secondary coronary events.
abstract: Comprehensive profiling of gene expression in peripheral blood leucocytes (PBLs) in patients with acute coronary syndrome (ACS) as a prognosticator is needed. We explored the specific profile of gene expression in PBLs in ACS for long-term risk stratification.
  
  
  
  30 patients with ACS who underwent primary percutaneous coronary intervention (PCI) and 15 age-matched adults who participated in medical check-ups were enrolled from three centres. Peripheral blood samples were collected to extract RNA for microarray analyses.
  
  
  
  During the 5-year follow-up, 36% of this cohort developed the expected non-fatal coronary events (NFEs) of target lesion revascularisation (TLR) and PCI for a de novo lesion. Class comparison analysis (p<0.005) demonstrated that 83 genes among 7785 prefiltered genes (41 upregulated vs 42 downregulated genes) were extracted to classify the patients according to the occurrence of NFE. Pathway analysis based on gene ontology revealed that the NFEs were associated with altered gene expression regarding the T-cell receptor signalling pathway in ACS. Univariate t test showed that the expression level of death-associated protein kinase1 (DAPK1), known to regulate inflammation, was the most significantly negatively regulated gene in the event group (0.61-fold, p<0.0005). Kaplan-Meier curve analysis and multivariate analysis adjusted for baseline characteristics or clinical biomarkers demonstrated that lower DAPK1 expression in PBL emerged as an independent risk factor for the NFEs (HR: 8.73; CI 1.05 to 72.8, p=0.045).
  
  
  
  Altered gene expression in T-cell receptor signalling in PBL in ACS could be a prognosticator for secondary coronary events.
  
  
  
  UMIN000001932; Results.
authors.affiliation: Department of Disease Control and Homeostasis , Kanazawa University Graduate School of Medical Science , Kanazawa, Ishikawa , Japan.
authors.forename: Shin-Ichiro
authors.initials: S
authors.lastname: Takashima
authors.affiliation: Department of Disease Control and Homeostasis , Kanazawa University Graduate School of Medical Science , Kanazawa, Ishikawa , Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Usui
authors.affiliation: Department of Disease Control and Homeostasis , Kanazawa University Graduate School of Medical Science , Kanazawa, Ishikawa , Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kurokawa
authors.affiliation: Department of Disease Control and Homeostasis , Kanazawa University Graduate School of Medical Science , Kanazawa, Ishikawa , Japan.
authors.forename: Teppei
authors.initials: T
authors.lastname: Kitano
authors.affiliation: Department of Disease Control and Homeostasis , Kanazawa University Graduate School of Medical Science , Kanazawa, Ishikawa , Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kato
authors.affiliation: Department of Disease Control and Homeostasis , Kanazawa University Graduate School of Medical Science , Kanazawa, Ishikawa , Japan.
authors.forename: Hisayoshi
authors.initials: H
authors.lastname: Murai
authors.affiliation: Department of Disease Control and Homeostasis , Kanazawa University Graduate School of Medical Science , Kanazawa, Ishikawa , Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Furusho
authors.affiliation: Public Central Hospital of Matto Ishikawa , Hakusan, Ishikawa , Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Oda
authors.affiliation: Toyama Prefectural Central Hospital , Toyama , Japan.
authors.forename: Michiro
authors.initials: M
authors.lastname: Maruyama
authors.affiliation: Toyama Prefectural Central Hospital , Toyama , Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Nagata
authors.affiliation: Toyama Prefectural Central Hospital , Toyama , Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Usuda
authors.affiliation: Public Central Hospital of Matto Ishikawa , Hakusan, Ishikawa , Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Kubota
authors.affiliation: Department of Disease Control and Homeostasis , Kanazawa University Graduate School of Medical Science , Kanazawa, Ishikawa , Japan.
authors.forename: Yumie
authors.initials: Y
authors.lastname: Takeshita
authors.affiliation: Department of Disease Control and Homeostasis , Kanazawa University Graduate School of Medical Science , Kanazawa, Ishikawa , Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Sakai
authors.affiliation: Department of Disease Control and Homeostasis , Kanazawa University Graduate School of Medical Science , Kanazawa, Ishikawa , Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Honda
authors.affiliation: Department of Disease Control and Homeostasis , Kanazawa University Graduate School of Medical Science , Kanazawa, Ishikawa , Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Kaneko
authors.affiliation: Department of Disease Control and Homeostasis , Kanazawa University Graduate School of Medical Science , Kanazawa, Ishikawa , Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Takamura