Michał Węgiel1, Joanna Wojtasik-Bakalarz2, Krzysztof Malinowski1, Marcin Surmiak3, Artur Dziewierz1, Danuta Sorysz4, Tomasz Tokarek4,5, Dariusz Dudek4, Stanisław Bartuś1, Andrzej Surdacki1, Tomasz Rakowski6. 1. Second Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland 2. Intensive Cardiology Care Unit, University Hospital in Krakow, Kraków, Poland 3. Department of Internal Medicine, Jagiellonian University Medical College, Kraków, Poland 4. Department of Cardiology and Cardiovascular Interventions, University Hospital in Krakow, Kraków, Poland 5. Center for Intensive Care and Perioperative Medicine, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland 6. Second Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland. mcrakows@cyfronet.pl
Abstract
INTRODUCTION: The main impact of myocardial infarction (MI) is shifting from acute mortality to adverse remodeling, chronic left ventricular (LV) dysfunction, and heart failure. OBJECTIVES: The aim of this study was to assess relationships between levels of circulating biomarkers and the function of LV after MI. PATIENTS AND METHODS: This was a prospective study of 80 patients with MI treated with percutaneous coronary intervention. Novel biomarkers including mid‑regional pro‑adrenomedullin (MR‑proADM), Notch‑1, syndecan‑4, myeloperoxidase, S‑100 protein, soluble ST‑2, as well as markers of inflammatory response and tissue injury: galectin‑3, C‑reactive protein (CRP), lactate dehydrogenase (LDH), and interleukin‑6 (IL‑6) were assessed in the acute phase of MI. Echocardiography was performed at baseline and 6 month Results: Adverse remodeling, defined as more than 20% increase in LV end‑diastolic volume, occurred in 26% of patients. Reverse remodeling (>10% reduction in LV end‑systolic volume) was observed in 52% of patients. In the univariable analysis, higher levels of MR‑proADM and LDH were predictors of adverse remodeling and higher levels of MR ‑proADM, LDH, CRP, and IL ‑6 were negative predictors of reverse remodeling. In the multivariable model, LDH remained an independent predictor of adverse remodeling (odds ratio [OR], 3.13; 95% CI, 1.42-8.18; P = 0.003) and a negative predictor of reverse remodeling (OR, 0.37; 95% CI, 0.17-0.8; P = 0.005). CONCLUSIONS: LDH and MR ‑proADM seem to be promising biomarkers of adverse remodeling. On the other hand, higher levels of these biomarkers were associated with reduced chance of occurrence of favorable reverse remodeling in MI patients. However, further studies on larger groups of patients are necessary to confirm these data.
INTRODUCTION: The main impact of myocardial infarction (MI) is shifting from acute mortality to adverse remodeling, chronic left ventricular (LV) dysfunction, and heart failure. OBJECTIVES: The aim of this study was to assess relationships between levels of circulating biomarkers and the function of LV after MI. PATIENTS AND METHODS: This was a prospective study of 80 patients with MI treated with percutaneous coronary intervention. Novel biomarkers including mid‑regional pro‑adrenomedullin (MR‑proADM), Notch‑1, syndecan‑4, myeloperoxidase, S‑100 protein, soluble ST‑2, as well as markers of inflammatory response and tissue injury: galectin‑3, C‑reactive protein (CRP), lactate dehydrogenase (LDH), and interleukin‑6 (IL‑6) were assessed in the acute phase of MI. Echocardiography was performed at baseline and 6 month Results: Adverse remodeling, defined as more than 20% increase in LV end‑diastolic volume, occurred in 26% of patients. Reverse remodeling (>10% reduction in LV end‑systolic volume) was observed in 52% of patients. In the univariable analysis, higher levels of MR‑proADM and LDH were predictors of adverse remodeling and higher levels of MR ‑proADM, LDH, CRP, and IL ‑6 were negative predictors of reverse remodeling. In the multivariable model, LDH remained an independent predictor of adverse remodeling (odds ratio [OR], 3.13; 95% CI, 1.42-8.18; P = 0.003) and a negative predictor of reverse remodeling (OR, 0.37; 95% CI, 0.17-0.8; P = 0.005). CONCLUSIONS: LDH and MR ‑proADM seem to be promising biomarkers of adverse remodeling. On the other hand, higher levels of these biomarkers were associated with reduced chance of occurrence of favorable reverse remodeling in MI patients. However, further studies on larger groups of patients are necessary to confirm these data.