Objective To investigate the impact of receptorinteracting protein kinase 3(RIPK3)on major adverse cardiovascular events(MACE)in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(P...Objective To investigate the impact of receptorinteracting protein kinase 3(RIPK3)on major adverse cardiovascular events(MACE)in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI),as well as the predictive performance of RIPK3 combined with traditional cardiovascular risk factors.MethodsThisstudyywasasingle-center prospective cohort study.It included patients with AMI who underwent PCI at Peking Union Medical College Hospital between September 2017 and November 2017.Baseline clinical data were collected,and plasma samples were obtained 6 hours after PCI to measure RIPK3 levels.Follow-up was conducted via outpatient visits or phone calls to record the occurrence of MACE,including cardiovascular death,hospitalization for heart failure,and vascular events(recurrent AMI or stroke).The predictiveperformance of RIPK3,traditional cardiovascular risk factors and their combination for MACE was compared using receiveroperating characteristic(ROC)curves.Patients were divided into low-and high-RIPK3 level groups based on the optimal cutoff value of RIPK3.Multivariate Cox proportional hazards regression analysis was used to assess the impact of RIPK3 levels on MACE after PCI in AMI patients.Kaplan-Meier survival curves were plotted,and the logrank test was used to compare MACE incidence between the low-and high-RIPK3 groups.Results A total of 103 AMI patients who underwent PCI were included,aged 63.0(56.0,69.0)years,and 83(80.6%)were male.The follow-up time was 5.17(2.81,5.17)years,during which 44 patients(42.7%)experienced MACE.The ROC curve analysis showed that the area under the curve(AUC)for traditional cardiovascular risk factors was 0.68(95%CI:0.58-0.78),while the AUC for plasma RIPK3 was 0.72(95%CI:0.62-0.82).The combined AUC for traditional risk factors and RIPK3 was 0.75(95%CI:0.65-0.85).MultivariateeCox proportional hazards regression analysis indicate1d that plasma RIPK3 level is greater than or equal to the optimal cutoff value of 440.9μg/L(HR=3.31,95%CI:1.53-8.30,P=0.005)was an independent risk factor for MACE in AMI patients after PCI.Kaplan-Meier survival analysis demonstrated that the high-RIPK3 group had a significantly higher risk of MACE after PCI compared to the low-RIPK3 group(log-rank P=0.006).Conclusion Elevated plasmaRIPK3level is an independent risk factor for MACE in AMI patients after PCI.Plasma RIPK3 combined with traditional cardiovascular risk factors can more effectively predict the occurrence of MACE in AMI patients after PCI.AMI patients with RIPK3≥440.9μg/L have a higher risk of MACE after PCI.展开更多
文摘Objective To investigate the impact of receptorinteracting protein kinase 3(RIPK3)on major adverse cardiovascular events(MACE)in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI),as well as the predictive performance of RIPK3 combined with traditional cardiovascular risk factors.MethodsThisstudyywasasingle-center prospective cohort study.It included patients with AMI who underwent PCI at Peking Union Medical College Hospital between September 2017 and November 2017.Baseline clinical data were collected,and plasma samples were obtained 6 hours after PCI to measure RIPK3 levels.Follow-up was conducted via outpatient visits or phone calls to record the occurrence of MACE,including cardiovascular death,hospitalization for heart failure,and vascular events(recurrent AMI or stroke).The predictiveperformance of RIPK3,traditional cardiovascular risk factors and their combination for MACE was compared using receiveroperating characteristic(ROC)curves.Patients were divided into low-and high-RIPK3 level groups based on the optimal cutoff value of RIPK3.Multivariate Cox proportional hazards regression analysis was used to assess the impact of RIPK3 levels on MACE after PCI in AMI patients.Kaplan-Meier survival curves were plotted,and the logrank test was used to compare MACE incidence between the low-and high-RIPK3 groups.Results A total of 103 AMI patients who underwent PCI were included,aged 63.0(56.0,69.0)years,and 83(80.6%)were male.The follow-up time was 5.17(2.81,5.17)years,during which 44 patients(42.7%)experienced MACE.The ROC curve analysis showed that the area under the curve(AUC)for traditional cardiovascular risk factors was 0.68(95%CI:0.58-0.78),while the AUC for plasma RIPK3 was 0.72(95%CI:0.62-0.82).The combined AUC for traditional risk factors and RIPK3 was 0.75(95%CI:0.65-0.85).MultivariateeCox proportional hazards regression analysis indicate1d that plasma RIPK3 level is greater than or equal to the optimal cutoff value of 440.9μg/L(HR=3.31,95%CI:1.53-8.30,P=0.005)was an independent risk factor for MACE in AMI patients after PCI.Kaplan-Meier survival analysis demonstrated that the high-RIPK3 group had a significantly higher risk of MACE after PCI compared to the low-RIPK3 group(log-rank P=0.006).Conclusion Elevated plasmaRIPK3level is an independent risk factor for MACE in AMI patients after PCI.Plasma RIPK3 combined with traditional cardiovascular risk factors can more effectively predict the occurrence of MACE in AMI patients after PCI.AMI patients with RIPK3≥440.9μg/L have a higher risk of MACE after PCI.
