Rodrigue Garcia1, Claire Bouleti2, Marc Sirol3, Damien Logeart4, Catherine Monnot5, Corinne Ardidie-Robouant5, Giuseppina Caligiuri6, Jean-Jacques Mercadier7, Stéphane Germain8. 1. CHU Poitiers, Service de Cardiologie, 2 rue de la Milétrie, 86021 Poitiers, France; Center for Interdisciplinary Research in Biology (CIRB), College de France, Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Paris Sciences et Lettres (PSL) Research University, 11, place Marcelin Berthelot, Paris F-75005, France. 2. Hôpital Bichat, APHP, Cardiology Department, 46 Rue Henri Huchard, 75877 Paris, Paris Diderot University, DHU Fire, France. 3. Hôpital Ambroise-Paré, 9 Avenue Charles de Gaulle, 92100 Boulogne-Billancourt, INSERM U1018, Team 5 Université Paris Sud-Université Versailles Saint Quentin en Yvelines, CESP (Centre for Epidemiology and Population Health EpReC Team, Renal and Cardiovascular Epidemiology), France. 4. Hopital Lariboisière, HEGP 2 rue Ambroise-Paré, 75010 Paris, France. 5. Center for Interdisciplinary Research in Biology (CIRB), College de France, Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Paris Sciences et Lettres (PSL) Research University, 11, place Marcelin Berthelot, Paris F-75005, France. 6. INSERM U 1148, Paris F-75018, France. 7. Signalisation and Cardiovascular Pathophysiology - UMR-S 1180, Univ. Paris-Sud, INSERM, Université Paris-Saclay, 92296, Châtenay-Malabry, France. 8. Center for Interdisciplinary Research in Biology (CIRB), College de France, Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Paris Sciences et Lettres (PSL) Research University, 11, place Marcelin Berthelot, Paris F-75005, France. Electronic address: stephane.germain@college-de-france.fr.
Abstract
BACKGROUND: Microvascular obstruction (MVO) is associated with poor outcome after ST-segment elevation myocardial infarction (STEMI). Vascular endothelial growth factor-A (VEGF-A) is a vascular permeability inducer playing a key role in MVO pathogenesis. We aimed to assess whether VEGF-A levels are associated with MVO, when evaluated by magnetic resonance imaging (MRI) in STEMI patients. METHODS: The multicenter prospective PREGICA study included a CMR substudy with all consecutive patients with a first STEMI who had undergone cardiac MRI at baseline and at 6-month follow-up. Patients with initial TIMI flow >1 were excluded. VEGF-A levels were measured in blood samples drawn at inclusion. RESULTS: Between 2010 and 2017, 147 patients (mean age 57 ± 10 years; 84% males) were included. MVO was present in 65 (44%) patients. After multivariate analysis, higher troponin peak (OR 1.005; 95% CI 1.001-1.008; p = 0.007) and VEGF-A levels (OR 1.003; 95% CI 1.001-1.005; p = 0.015) were independently associated with MVO. When considering only patients with successful percutaneous coronary intervention (final TIMI flow 3, n = 130), higher troponin peak (p = 0.004) and VEGF-A levels (p = 0.03) remained independently predictive of MVO. Moreover, MVO was associated with adverse left ventricular (LV) remodeling and VEGF-A levels were significantly and inversely correlated with LV ejection fraction (EF) at 6-month follow-up. CONCLUSION: Our results show that VEGF-A levels were independently associated with MVO during STEMI and correlated with mid-term LVEF alteration. VEGF-A could therefore be considered as a biomarker of MVO in STEMI patients and be used to stratify patient prognosis.
BACKGROUND:Microvascular obstruction (MVO) is associated with poor outcome after ST-segment elevation myocardial infarction (STEMI). Vascular endothelial growth factor-A (VEGF-A) is a vascular permeability inducer playing a key role in MVO pathogenesis. We aimed to assess whether VEGF-A levels are associated with MVO, when evaluated by magnetic resonance imaging (MRI) in STEMI patients. METHODS: The multicenter prospective PREGICA study included a CMR substudy with all consecutive patients with a first STEMI who had undergone cardiac MRI at baseline and at 6-month follow-up. Patients with initial TIMI flow >1 were excluded. VEGF-A levels were measured in blood samples drawn at inclusion. RESULTS: Between 2010 and 2017, 147 patients (mean age 57 ± 10 years; 84% males) were included. MVO was present in 65 (44%) patients. After multivariate analysis, higher troponin peak (OR 1.005; 95% CI 1.001-1.008; p = 0.007) and VEGF-A levels (OR 1.003; 95% CI 1.001-1.005; p = 0.015) were independently associated with MVO. When considering only patients with successful percutaneous coronary intervention (final TIMI flow 3, n = 130), higher troponin peak (p = 0.004) and VEGF-A levels (p = 0.03) remained independently predictive of MVO. Moreover, MVO was associated with adverse left ventricular (LV) remodeling and VEGF-A levels were significantly and inversely correlated with LV ejection fraction (EF) at 6-month follow-up. CONCLUSION: Our results show that VEGF-A levels were independently associated with MVO during STEMI and correlated with mid-term LVEF alteration. VEGF-A could therefore be considered as a biomarker of MVO in STEMI patients and be used to stratify patient prognosis.
Authors: Han Wu; Ran Li; Kun Wang; Dan Mu; Jian-Zhou Chen; Xuan Wei; Xue Bao; Zhong-Hai Wei; Jun Xie; Biao Xu Journal: Cardiol Res Pract Date: 2020-09-26 Impact factor: 1.866
Authors: Raquel Del Toro; Isabel Galeano-Otero; Elisa Bevilacqua; Francisco Guerrero-Márquez; Debora Falcon; Agustín Guisado-Rasco; Luis Díaz-de la Llera; Gonzalo Barón-Esquivias; Tarik Smani; Antonio Ordóñez-Fernández Journal: Front Cardiovasc Med Date: 2022-03-24