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Post-reperfusion enhancement of CD14(+)CD16(-) monocytes and microvascular obstruction in ST-segment elevation acute
Hiroto Tsujioka1, Toshio Imanishi, Hideyuki Ikejima
1Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
Background:
The presence of microvascular obstruction (MVO) after primary ST-segment elevation acute myocardial infarction (STEMI) is associated with a poor outcome. The aim of the paper was to examine the relationship between distinct monocyte subsets and gadolinium-enhanced cardiovascular magnetic resonance (CMR) characteristics of MVO after STEMI.
Methods And Results:
Seventy-one patients with primary STEMI successfully treated with stenting were enrolled in the study. Two monocyte subsets (CD14(+)CD16(-) and CD14(+)CD16(+)) were measured on flow cytometry on admission and 2, 3, 4, 5, 8 days after the onset of STEMI. CMR was performed 7 days after revascularization to determine MVO on late gadolinium-enhanced imaging. The peak levels of CD14(+)CD16(-) monocytes, but not those of CD14(+)CD16(+) monocytes, were significantly higher in patients with MVO than in those without MVO. A multivariate logistic regression model showed that the post-perfusion peak levels of CD14(+)CD16(-) monocytes remained an independent factor for the presence of MVO (odds ratio=1.53; 95% confidence interval: 1.01-2.32; P=0.04). The absence of MVO was significantly associated with improvement in left ventricular ejection fraction.
Conclusions:
Post-reperfusion enhancement of CD14(+)CD16(-) monocytes was associated with MVO in patients with STEMI. The pathophysiologic and therapeutic implications of this association require further study.
Insights
Elevated CD14(+)CD16(-) monocytes after ST-segment elevation myocardial infarction (STEMI) indicate microvascular obstruction (MVO). This finding may help predict patient outcomes following treatment.
Area of Science:
- Cardiology
- Immunology
- Biomarkers
Background:
- Microvascular obstruction (MVO) post-ST-segment elevation myocardial infarction (STEMI) correlates with adverse patient outcomes.
- Understanding MVO predictors is crucial for improving STEMI management.
Purpose of the Study:
- To investigate the association between specific monocyte subsets and MVO characteristics determined by cardiovascular magnetic resonance (CMR) in STEMI patients.
Main Methods:
- Seventy-one STEMI patients treated with stenting were analyzed.
- Monocyte subsets (CD14(+)CD16(-) and CD14(+)CD16(+)) were quantified via flow cytometry.
- Late gadolinium-enhanced CMR assessed MVO 7 days post-revascularization.
Main Results:
- Peak CD14(+)CD16(-) monocyte levels were significantly higher in patients with MVO compared to those without.
- CD14(+)CD16(-) monocyte levels independently predicted MVO presence (OR=1.53, P=0.04).
- Absence of MVO correlated with improved left ventricular ejection fraction.
Conclusions:
- Post-reperfusion CD14(+)CD16(-) monocyte levels are linked to MVO in STEMI patients.
- Further research is needed to clarify the pathophysiologic and therapeutic implications of this association.
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