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Association between plasma chromogranin A concentration and long-term mortality after myocardial infarction
Torbjørn Omland1, Kenneth Dickstein, Unni Syversen
1Department of Cardiology, The National Hospital, Oslo, Norway. torbjorn.omland@rikshospitalet.no
Insights
Elevated chromogranin A levels after myocardial infarction may indicate increased long-term mortality risk. This biomarker reflects neuroendocrine activation, offering prognostic insights for heart attack survivors.
Area of Science:
- Cardiology
- Neuroendocrinology
- Biomarker Research
Background:
- Chromogranin A is a polypeptide found in the neuroendocrine system.
- It may serve as a marker for neuroendocrine activation.
- Its prognostic value after myocardial infarction is not fully understood.
Purpose of the Study:
- To assess the long-term prognostic significance of circulating chromogranin A levels.
- To investigate the association between chromogranin A and mortality post-myocardial infarction.
Main Methods:
- Study included 119 patients with documented myocardial infarction.
- Plasma chromogranin A levels were measured by radioimmunoassay 3 days post-symptom onset.
- Median follow-up was 10.8 years.
Main Results:
- A total of 56 patients (47%) died during follow-up.
- Higher plasma chromogranin A levels correlated with increased long-term mortality (HR=1.17 per 10 ng/mL increase).
- Adjusted models considered age, heart failure, and thrombolytic therapy.
Conclusions:
- Plasma chromogranin A levels are associated with long-term mortality after myocardial infarction.
- This association may be due to chromogranin A reflecting neuroendocrine activation.
- Chromogranin A shows potential as a prognostic biomarker in post-MI patients.
Purpose:
Chromogranin A, a polypeptide that is distributed throughout the neuroendocrine system, may be a marker of neuroendocrine activation. We sought to assess the long-term prognostic value of circulating levels of chromogranin A after myocardial infarction.
Methods:
We studied 119 patients (88 [74%] male; median age, 70 years [interquartile range, 62 to 75 years]) with documented myocardial infarction. Chromogranin A levels in plasma were determined by radioimmunoassay from samples obtained 3 days after the onset of symptoms.
Results:
During a median follow-up of 10.8 years, 56 patients (47%) died. The median concentration of chromogranin A in plasma was 24 ng/mL (interquartile range, 18 to 36 ng/mL). Plasma chromogranin A levels were associated with increased long-term mortality (hazard ratio [HR] = 1.17 per 10-ng/mL increase; 95% confidence interval [CI]: 1.06 to 1.28) in models that adjusted for age, clinical heart failure during the initial hospitalization, and use of thrombolytic therapy. As a dichotomous variable (cutoff, 24 ng/mL), an elevated chromogranin A level was also associated with mortality in univariate analysis (HR = 2.6; 95% CI: 1.4 to 4.8), but this relation was no longer significant after adjustment for age (HR = 1.4; 95% CI: 0.8 to 2.7).
Conclusion:
Plasma levels of chromogranin A are related to long-term mortality after myocardial infarction, perhaps because they reflect neuroendocrine activation.