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Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Impact of soluble fms-like tyrosine kinase-1 and placental growth factor serum levels for risk stratification and
Willibald Hochholzer1, Tobias Reichlin, Claudia Stelzig
1Department of Internal Medicine, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland.
Soluble fms-like tyrosine kinase-1 (sFlt-1) predicts mortality in acute myocardial infarction (AMI) patients independently. While sFlt-1 aids early AMI diagnosis with troponin T, its added value diminishes with high-sensitive troponin assays.
Area of Science:
- Cardiovascular Medicine
- Biomarkers
- Atherosclerosis Research
Background:
- Angiogenic factors are implicated in atherosclerosis development.
- Acute myocardial infarction (AMI) is associated with significant changes in angiogenic factors.
Purpose of the Study:
- To analyze the impact of placental growth factor (PlGF) and its antagonist soluble fms-like tyrosine kinase-1 (sFlt-1) on clinical outcomes.
- To evaluate the role of PlGF and sFlt-1 in the early diagnosis of AMI.
Main Methods:
- Multicenter study of 763 patients with symptoms suggestive of AMI.
- Comparison of sFlt-1 and PlGF levels with troponin T and high-sensitive troponin (hsTnT) assays.
- Multivariable Cox regression analysis for mortality prediction and diagnostic performance assessment.
Main Results:
- sFlt-1 >84 ng/L and PlGF >20 ng/L were independent predictors of 1-year mortality, irrespective of troponin T and NT-proBNP.
- sFlt-1 remained an independent predictor of mortality when analyzed with hsTnT and NT-proBNP.
- Combining troponin T with sFlt-1 improved AMI diagnosis, yielding a 98.3% negative predictive value at presentation.
Conclusions:
- sFlt-1, but not PlGF, provides independent prognostic information in patients presenting with AMI symptoms.
- The diagnostic utility of sFlt-1 and PlGF for AMI detection is limited when used with hsTnT assays.
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