Gianluca Pontone1, Daniele Andreini2, Andrea I Guaricci3, Marco Guglielmo4, Andrea Baggiano4, Giuseppe Muscogiuri4, Laura Fusini4, Fabio Fazzari5, Claudio Berzovini6, Annalisa Pasquini7, Saima Mushtaq4, Edoardo Conte4, Nicola Cosentino4, Mark G Rabbat8, Giancarlo Marenzi4, Antonio L Bartorelli9, Mauro Pepi4, Elena Tremoli4, Cristina Banfi4. 1. Centro Cardiologico Monzino, IRCCS, Milan, Italy. Electronic address: gianluca.pontone@ccfm.it. 2. Centro Cardiologico Monzino, IRCCS, Milan, Italy; Department of Cardiovascular Sciences and Community Health, University of Milan, Milan, Italy. 3. Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital "Policlinico" of Bari, Bari, Italy; Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy. 4. Centro Cardiologico Monzino, IRCCS, Milan, Italy. 5. Department of Cardiology, University Hospital P. Giaccone, Palermo, Italy. 6. Department of Surgical Sciences, Radiology Institute, University of Turin, Turin, Italy. 7. Department of Cardiology, "La Sapienza" University of Rome, Rome, Italy. 8. Loyola University of Chicago, Chicago, Illinois; Edward Hines Jr. VA Hospital, Hines, Illinois. 9. Centro Cardiologico Monzino, IRCCS, Milan, Italy; Department of Biomedical and Clinical Sciences "Luigi Sacco," University of Milan, Milan, Italy.
Abstract
OBJECTIVES: This study aimed to evaluate the correlation between different haptoglobin (Hp) phenotypes and myocardial infarction characteristics as detected by cardiac magnetic resonance (CMR) in consecutive patients after ST-segment elevation myocardial infarction (STEMI). BACKGROUND: Hp is a plasma protein that prevents iron-mediated oxidative tissue damage. CMR has emerged as the gold standard technique to detect left ventricular ejection fraction (LVEF), extent of scar with late gadolinium enhancement (LGE) technique, microvascular obstruction (MVO), and myocardial hemorrhage (MH) in patients with STEMI treated by primary percutaneous coronary intervention (pPCI). METHODS: A total of 145 consecutive STEMI patients (mean age 62.2 ± 10.3 years; 78% men) were prospectively enrolled and underwent Hp phenotyping and CMR assessment within 1 week after STEMI. RESULTS: CMR showed an area at risk (AAR) involving 26.6 ± 19.1% of left ventricular (LV) mass with a late LGE extent of 15.2 ± 13.1% of LV mass. MVO and MH occurred in 38 (26%) and 12 (8%) patients, respectively. Hp phenotypes 1-1, 2-1, 2-2 were observed in 15 (10%), 62 (43%), and 68 (47%), respectively. Multivariable analysis demonstrated that body mass index, Hp2-2, diabetes, and peak troponin I were independent predictors of MVO with Hp2-2 associated with the highest odds ratio (OR) (OR: 5.5 [95% confidence interval [CI]: 2.1 to 14.3; p < 0.001]). Hp2-2 significantly predicted both the presence (area under the curve [AUC]: 0.63 [95% CI: 0.53 to 0.72; p = 0.008]) and extent of MVO (AUC: 0.63 [95% CI: 0.54 to 0.72; p = 0.007]). CONCLUSIONS: Hp phenotype is an independent predictor of MVO. Therefore, Hp phenotyping could be used for risk stratification and may be useful in assessing new therapies to reduce myocardial reperfusion injury in patients with STEMI.
OBJECTIVES: This study aimed to evaluate the correlation between different haptoglobin (Hp) phenotypes and myocardial infarction characteristics as detected by cardiac magnetic resonance (CMR) in consecutive patients after ST-segment elevation myocardial infarction (STEMI). BACKGROUND: Hp is a plasma protein that prevents iron-mediated oxidative tissue damage. CMR has emerged as the gold standard technique to detect left ventricular ejection fraction (LVEF), extent of scar with late gadolinium enhancement (LGE) technique, microvascular obstruction (MVO), and myocardial hemorrhage (MH) in patients with STEMI treated by primary percutaneous coronary intervention (pPCI). METHODS: A total of 145 consecutive STEMI patients (mean age 62.2 ± 10.3 years; 78% men) were prospectively enrolled and underwent Hp phenotyping and CMR assessment within 1 week after STEMI. RESULTS: CMR showed an area at risk (AAR) involving 26.6 ± 19.1% of left ventricular (LV) mass with a late LGE extent of 15.2 ± 13.1% of LV mass. MVO and MH occurred in 38 (26%) and 12 (8%) patients, respectively. Hp phenotypes 1-1, 2-1, 2-2 were observed in 15 (10%), 62 (43%), and 68 (47%), respectively. Multivariable analysis demonstrated that body mass index, Hp2-2, diabetes, and peak troponin I were independent predictors of MVO with Hp2-2 associated with the highest odds ratio (OR) (OR: 5.5 [95% confidence interval [CI]: 2.1 to 14.3; p < 0.001]). Hp2-2 significantly predicted both the presence (area under the curve [AUC]: 0.63 [95% CI: 0.53 to 0.72; p = 0.008]) and extent of MVO (AUC: 0.63 [95% CI: 0.54 to 0.72; p = 0.007]). CONCLUSIONS: Hp phenotype is an independent predictor of MVO. Therefore, Hp phenotyping could be used for risk stratification and may be useful in assessing new therapies to reduce myocardial reperfusion injury in patients with STEMI.
Authors: Adriana Argentiero; Giuseppe Muscogiuri; Mark G Rabbat; Chiara Martini; Nicolò Soldato; Paolo Basile; Andrea Baggiano; Saima Mushtaq; Laura Fusini; Maria Elisabetta Mancini; Nicola Gaibazzi; Vincenzo Ezio Santobuono; Sandro Sironi; Gianluca Pontone; Andrea Igoren Guaricci Journal: J Clin Med Date: 2022-05-19 Impact factor: 4.964
Authors: Giuseppe Muscogiuri; Andrea Igoren Guaricci; Nicola Soldato; Riccardo Cau; Luca Saba; Paola Siena; Maria Grazia Tarsitano; Elisa Giannetta; Davide Sala; Paolo Sganzerla; Marco Gatti; Riccardo Faletti; Alberto Senatieri; Gregorio Chierchia; Gianluca Pontone; Paolo Marra; Mark G Rabbat; Sandro Sironi Journal: J Clin Med Date: 2022-09-26 Impact factor: 4.964