Biomarcadores con implicación pronóstica a largo plazo en los síndromes coronarios agudos

Identificador:  TDX:3929

Handle: https://hdl.handle.net/20.500.11797/TDX3929

Autors:  Peiró Ibáñez, Óscar Manuel

Resum:
Patients suffering from acute coronary syndrome are at high risk of long-term adverse events. Therefore, it is necessary to identify those patients with higher risk to initiate secondary prevention measures. Biomarkers have recently been identified as a tool to stratify risk in these patients. It is hypothesized that detection of elevated plasma concentrations of SDF-1, GDF-15, or suPAR in patients hospitalized for acute coronary syndrome may provide relevant prognostic information. Thus, the objective of this doctoral thesis was to analyze the ability of these biomarkers to predict long-term adverse events in patients hospitalized for acute coronary syndrome. The doctoral thesis includes three studies carried out in patients with acute coronary syndrome followed-up at long-term. The first study demonstrated that patients with high plasma levels of SDF-1 had an increased risk of mortality and the composite of major adverse cardiovascular and cerebrovascular events. In the second study, subjects with high plasma concentrations of GDF-15 had a higher prevalence of cardiovascular risk factors and cardiovascular history and, also, had an increased risk of mortality, heart failure, and the composite of major adverse cardiovascular events. In the third study, suPAR was able to identify patients with the highest risk of mortality, heart failure, and the composite of major cardiovascular adverse events. Additionally, all three biomarkers were able to provide additional prognostic information beyond traditional risk factors. Therefore, the research supports, among other implications, the use of these biomarkers for risk stratification in patients admitted for acute coronary syndrome. And it highlights the need to design more intensive therapeutic strategies and closer follow-up among those subjects with higher risk.