Objectives

Proprotein convertase subtilisin/kexin (PCSK) family member 3 (FURIN) has been suggested to be involved in the development of atherosclerosis. The aim of this study was to investigate the prognostic implication of FURIN in patients after acute myocardial infarction (AMI).

Methods

This prospective study analyzed data from a total of 1312 consecutive patients hospitalized with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction from August 2013 to June 2016. FURIN levels were analyzed in plasma obtained from AMI patients.

Results

The study included 1312 AMI patients. The patient population was predominantly male (63%) with a median age of 66 years (IQR: 19 years), and 59% were STEMI patients. During a follow-up of 2 years, 117 patients died, and 377 patients reached the combined endpoints of major adverse cardiac events (MACE). Patients with elevated FURIN levels had increased risk of MACE, all-cause mortality, recurrent MI and hospitalization for HF (log-rank test, p < 0.0001). After adjusting for clinical risk factors and established markers, the association of FURIN concentrations with the risk of MACE and its individual components and cardiovascular death was statistically significant in the higher tertile of FURIN concentrations. After the addition of FURIN to the models, FURIN showed additive prognostic significance for 2-year clinical outcomes. Variable importance plots of the models showed that FURIN was of high importance to predict both occurrence of MACE and all-cause mortality.

Conclusions

We found that FURIN was associated with all-cause mortality and recurrent cardiovascular events in AMI patients independent of conventional risk factors and established markers.

中文翻译：

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FURIN水平升高可预测急性心肌梗死患者的死亡率和心血管事件。

目标

前蛋白转化酶枯草杆菌蛋白酶/ kexin（PCSK）家庭成员3（FURIN）已被建议参与动脉粥样硬化的发展。这项研究的目的是调查急性心梗（AMI）患者中FURIN的预后意义。

方法

该前瞻性研究分析了2013年8月至2016年6月共1312例住院的ST段抬高型心肌梗塞（STEMI）和非ST段抬高型心肌梗塞的住院患者的数据。分析了AMI患者血浆中的FURIN水平。

结果

该研究包括1312例AMI患者。患者人群主要是男性（63％），中位年龄为66岁（IQR：19岁），而STEMI患者为59％。在2年的随访中，有117例患者死亡，有377例患者达到了主要不良心脏事件（MACE）的综合终点。FURIN水平升高的患者发生MACE，全因死亡率，MI复发和HF住院的风险增加（log-rank test，p <0.0001）。在调整了临床危险因素并建立了标记后，在较高的三分位数的FURIN浓度下，FURIN浓度与MACE及其单个成分与心血管死亡的风险之间的相关性在统计学上显着。在模型中加入FURIN后，FURIN对2年临床结果显示出附加的预后意义。模型的可变重要性图表明，FURIN对预测MACE的发生和全因死亡率均具有很高的重要性。

结论

我们发现FURIN与AMI患者的全因死亡率和复发性心血管事件相关，而与常规危险因素和既定标志物无关。