RESUMO
OBJECTIVES: To explore the prognostic value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and uric acid (UA) in acute ST-segment elevation myocardial infarction (STEMI) patients after complete revascularization (CR). METHODS: The clinical and physical data from 125 acute STEMI patients (research group) who underwent CR between December 2017 and December 2020 and 60 healthy individuals (control group) who concurrently underwent physical examinations in the Affiliated Hospital of Guizhou Medical University were retrospectively analyzed in this study. Serum samples were collected from both groups to determine the levels of NT-proBNP and UA. The 3-year follow-up data of acute STEMI patients were collected, which were used to group the patients into a good and a poor prognosis group based on their prognoses to comparatively analyze NT-proBNP and UA levels. Receiver operating characteristic (ROC) curves were drawn to analyze the prognostic value of NT-proBNP and UA in STEMI patients following CR, and survival curves were plotted to observe their influences on patients' 3-year overall survival (OS). Meanwhile, a univariate analysis was conducted to identify factors associated with the 3-year OS of acute STEMI patients after CR. RESULTS: The data showed significantly higher expression levels of serum NT-proBNP and UA in acute STEMI patients than in the controls. Besides, the good prognosis group exhibited markedly lower serum NT-proBNP and UA levels than the poor prognosis group. The areas under the curve (AUCs) of NT-proBNP and UA in predicting the prognosis of acute STEMI patients after CR were all above 0.700, and the AUC of their combined detection reached over 0.800. In addition, high serum NT-proBNP and UA levels were strongly associated with lower 3-year OS rates. As indicated by the univariate analysis, a history of smoking and alcoholism as well as high NT-proBNP and UA levels were closely associated with 3-year OS in acute STEMI patients after CR. CONCLUSIONS: NT-proBNP and UA have promising prognostic value in acute STEMI after CR.
RESUMO
Previous reports implicate XRCC1 Arg399Gln polymorphism as a possible risk factor for several cancers. Increasing studies have been conducted on the association of XRCC1 Arg399Gln polymorphisms with susceptibility to leukemia. However, conflicting results have been generated. The goal of the present study was to derive a more precise estimation of the relationship. Meta-analyses assessing the association of XRCC1 Arg399Gln variation with leukemia were conducted, and subgroup analyses on ethnicity and clinical types were further performed. Eligible studies were identified for the period up to February 2013. Consequently, 16 publications including 17 case-control studies with 2,647 cases and 5,518 controls were selected for analysis. The overall data indicated a significant association of XRCC1 Arg399Gln polymorphism with leukemia risk (Gln/Gln versus Arg/Arg: OR = 1.37, 95% confidence interval (CI) = 1.08-1.74; dominant model: OR = 1.23, 95%CI = 1.03-1.46; recessive model: OR = 1.23, 95%CI = 1.06-1.44). In the subgroup analysis by ethnicity, Gln allele may increase leukemia susceptibility among Asians (Gln/Gln versus Arg/Arg: OR = 1.82, 95%CI = 1.19-2.78; dominant model: OR = 1.53, 95%CI = 1.00-2.33; recessive model: OR = 1.51, 95%CI = 1.11-2.06), but not Caucasians or mixed ethnicities. In the subgroup analysis by clinical types, increased risk was observed in acute lymphocytic leukemia (ALL) subgroup (Gln/Gln versus Arg/Arg: OR = 1.45, 95%CI = 1.09-1.93; recessive model: OR = 1.30, 95%CI = 1.00-1.69), but not in acute myeloid leukemia, chronic lymphocytic leukemia, or chronic myeloid leukemia subgroups, respectively. Collectively, the results of the present study suggest that XRCC1 Arg399Gln polymorphism might be a low-penetrant risk factor for leukemia, particularly among Asians. Homozygous Gln/Gln alleles might have a correlation with increased ALL susceptibility.