α1-Antichymotrypsin Complex (SERPINA3) Is an Independent Predictor of All-Cause but Not Cardiovascular Mortality in Patients Hospitalized for Chest Pain of Suspected Coronary Origin

α1-抗胰凝乳蛋白酶复合物 (SERPINA3) 是因疑似冠心病胸痛住院患者的全因死亡率而非心血管死亡率的独立预测因子

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作者:Dennis Winston T Nilsen, Reidun Aarsetoey, Volker Poenitz, Thor Ueland, Pål Aukrust, Annika Elisabet Michelsen, Trygve Brugger-Andersen, Harry Staines, Heidi Grundt

Conclusions

SERPINA3 predicts long-term all-cause mortality but fails to predict outcome in AMI patients.

Methods

A total of 871 consecutive patients, 386 diagnosed with AMI, were included. Stepwise Cox regression models, applying continuous loge-transformed values, were fitted for the biomarker with all-cause mortality and cardiac death within 2 years or all-cause mortality within the median 7 years as dependent variables. An analysis of MI and stroke, and combined endpoints, respectively, was added. The hazard ratio (HR) (95% CI) was assessed in a univariate and multivariable model.

Results

Plasma samples from 847 patients were available. By 2-year follow-up, 138 (15.8%) patients had died, of which 86 were cardiac deaths. The univariate analysis showed a significant association between SERPINA3 and all-cause mortality (HR 1.41 [95% 1.19-1.68], p < 0.001) but not for cardiac death. Associations after adjustment were non-significant. By 7-year follow-up, 332 (38.1%) patients had died. SERPINA3 was independently associated with all-cause mortality from the third year onward. The HR was 1.14 (95% CI, 1.02-1.28), p = 0.022. Similar results applied to combined endpoints, but not for MI and stroke, respectively. The prognostic value of SERPINA3 was limited to non-AMI patients. No independent associations were noted among AMI patients. Conclusions: SERPINA3 predicts long-term all-cause mortality but fails to predict outcome in AMI patients.

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