[1]李瑞婷 马月 马锐 张荣秀 刘占文.表观生物年龄加速预测老年重度冠状动脉钙化患者行冠脉旋磨术后主要不良心血管事件的研究[J].心血管病学进展,2025,(4):362.[doi:10.16806/j.cnki.issn.1004-3934.2025.04.017]
　Li Ruiting,Ma Yue,Ma Rui,et al.Association Between Epigenetic Age Acceleration and Major Adverse Cardiovascular Events in Elderly Patients with Severe Coronary Artery Calcification after Rotational Atherectomy[J].Advances in Cardiovascular Diseases,2025,(4):362.[doi:10.16806/j.cnki.issn.1004-3934.2025.04.017]
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表观生物年龄加速预测老年重度冠状动脉钙化患者行冠脉旋磨术后主要不良心血管事件的研究()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2025年4期
页码:
362
栏目:
论著
出版日期:
2025-04-25

文章信息/Info

Title:
Association Between Epigenetic Age Acceleration and Major Adverse Cardiovascular Events in Elderly Patients with Severe Coronary Artery Calcification after Rotational Atherectomy
作者:
李瑞婷 马月 马锐 张荣秀 刘占文
(新疆维吾尔自治区第三人民医院心血管内科 新疆 乌鲁木齐 830000)
Author(s):
Li Ruiting; Ma Yue; Ma Rui; Zhang Rongxiu; Liu Zhanwen
(Cardiovascular Medicine Department,The Third People’s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830000,Xinjiang ,China)
关键词:
表观生物年龄加速; 冠状动脉钙化; 老年患者; 冠脉旋磨术; 主要不良心血管事件
Keywords:
Epigenetic age acceleration; Coronary artery calcification; Elderly patient; Rotational atherectomy; Major adverse cardiovascular events
DOI:
10.16806/j.cnki.issn.1004-3934.2025.04.017
摘要:
目的 探讨表观生物年龄加速（EAA）与老年严重冠状动脉钙化（CAC）患者行冠状动脉旋磨术（RA）后发生主要不良心血管事件（MACE）之间的关系。方法 回顾性选取2013年7月—2023年8月在新疆维吾尔自治区第三人民医院接受RA的老年严重CAC患者共206例。终点事件为发生MACE，中位随访时间为49.0个月。通过计算EAA，将患者分为EAA﹢组（表观年龄＞实际年龄）与EAA﹣组（表观年龄＜实际年龄），探究EAA与老年严重CAC患者行RA后发生MACE之间的关系。采用Kaplan-Meier生存分析探究EAA与老年严重CAC患者行RA后发生MACE之间的相关性。采用单因素Cox回归分析MACE发生的危险因素，将结果进一步纳入多因素Cox回归分析，并构建术后发生MACE的列线图；采用受试者工作特征曲线（ROC）、决策曲线（DCA）和校准曲线分析EAA对MACE发生的预测价值。结果 Kaplan?Meier生存分析发现，EAA﹣组的无MACE累计生存率更高（P=0.007）。Cox回归分析发现EAA在模型调整后在EAA﹢等中仍与MACE的发生具有显著相关性（P<0.05）。RCS曲线显示EAA与MACE的发生呈线性相关（P的非线性值=0.619）。ROC曲线显示，在1年、3年、5年和8年内AUC分别为0.72、0.76、0.78和0.75；DCA曲线结果也表明EAA对MACE事件的发生具有良好的预测作用；校准曲线显示EAA具有较高准确度。列线图可视化预测患者的MACE发生风险。结论 EAA与老年严重CAC患者行RA后发生MACE之间存在相关性，可帮助医护人员识别高危患者并改善患者的不良预后。
Abstract:
Objective To investigate the relationship between epigenetic age acceleration (EAA) and the occurrence of major adverse cardiovascular events (MACE) after rotational atherectomy (RA) in elderly patients with severe coronary artery calcification (CAC). Methods A retrospective study was conducted on a total of 206 elderly patients with severe CAC who underwent RA at the Third People’s Hospital of xinjiang uygur autonomous region Cardiovascular medicine department from July 201 3 to August 202 3. The patients were categorized into EAA﹢ group (PhenoAge > actual age) and EAA ﹣ group (PhenoAge < actual age) based on their calculated phenotypic age (PhenoAge). The association between EAA and the occurrence of MACE after RA in elderly patients with severe CAC was explored using Kaplan-Meier survival analysis. Cox proportional hazards regression models were used to identify risk factors for MACE occurrence ,and these results were further included in a multivariable Cox regression analysis. Receiver operating characteristic curve(ROC),decision curve analysis(DCA),and calibration curve were used to examine the predictive value of EAA for MACE occurrence. Results Kaplan-Meier survival analysis revealed a higher cumulative survival rate without MACE in the EAA﹣ group( P=0.007). Cox regression analysis showed that after adjusting for EAA﹢,inpatient MACE,fasting blood sugar,glycated hemoglobin,and NT-BNP were still significantly associated with the occurrence of MACE(P<0.05). Restricted cubic spline(RCS) analysis indicated no linear relationship between EAA and MACE occurrence(P for nonlinear=0.619). The AUC values for the ROC curve at 1 ,3,5,and 8 years were 0.72,0.76,0.78,and 0.75,respectively. DCA results also demonstrated the good predictive value of EAA for MACE events,while the Calibration Curve indicated a high model accuracy. The nomogram visualized the risk of MACE occurrence in patients. Conclusion There is a relationship between EAA and the occurrence of MACE after RA in elderly patients with severe CAC,which can help healthcare providers identify high-risk patients and improve patient outcomes

参考文献/References:

[1] Madhavan MV,Tarigopula M,Mintz GS,et al. Coronary artery calcification:pathogenesis and prognostic implications[J]. J Am Coll Cardiol,2014,63(17):1703-1714.

[2] 王伟民,霍勇,葛均波. 冠状动脉钙化病变诊治中国专家共识(2021版) [J]. 中国介入心脏病学杂志,2021,29(5):251-259.

[3] Lawton JS,Tamis-Holland JE,Bangalore S,et al. 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization:a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[J]. Circulation,2022,145(3):e18-e114.

[4] Gialluisi A,Santoro A,Tirozzi A,et al. Epidemiological and genetic overlap among biological aging clocks:new challenges in biogerontology[J]. Ageing Res Rev,2021,72:101502.

[5] Duan R,Fu Q,Sun Y,et al. Epigenetic clock:a promising biomarker and practical tool in aging[J]. Ageing Res Rev ,2022,81:101743.

[6] Levine ME,Lu AT,Quach A,et al. An epigenetic biomarker of aging for lifespan and healthspan[J]. Aging(Albany NY),2018,10(4):573-591.

[7] Murthy M,Rizzu P,Heutink P,et al. Epigenetic age acceleration in frontotemporal lobar degeneration:a comprehensive analysis in the blood and brain[J]. Cells,2023,12(14):1922.

[8] Vaccarino V,Huang M,Wang Z,et al. Epigenetic age acceleration and cognitive decline:a twin study[J]. J Gerontol A Biol Sci Med Sci,2021,76(10):1854-1863.

[9] Liu Z,Kuo PL,Horvath S,et al. A new aging measure captures morbidity and mortality risk across diverse subpopulations from NHANES IV:a cohort study[J]. PLoS Med ,2018,15(12):e1002718.

[10] 徐国宾. 糖尿病诊断标准的完善及糖化血红蛋白A1c检测的标准化[J]. 临床检验杂志,2012,30(6):401-405.

[11] 陈建华,宋和平,陆瑾. 国内外高血压诊断标准比较[J]. 中西医结合心脑血管病杂志,2014,(5):527-528.

[12] 赵安琪,杨玲,查晴,等. 血清艾帕素-12水平与冠状动脉钙化的相关性研究[J]. 内科理论与实践,2024,19(2):107-114.

[13] 王仁辉,于子翔,程琦,等. 严重冠状动脉钙化病变患者行冠状动脉旋磨术后远期预后预测模型建立与评价[J]. 中国心血管病研究,2024,22(5):433-440.

[14] Inkster AM,Duarte-Guterman P,Albert AY,et al. Are sex differences in cognitive impairment reflected in epigenetic age acceleration metrics?[J]. Neurobiol Aging,2022,109:192-194.

[15] 刘玉玲. 表观遗传年龄加速度在冠心病队列中与血浆代谢物、冠心病相关疾病和预后的研究[D]. 华南理工大学 ,2022.

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更新日期/Last Update: 2025-05-16