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Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction
Published on: October 14, 2016
[Evaluation of plasma renin activity in acute myocardial infarction patients treated with primary percutaneous
Piotr J Stryjewski1, Artur Z Pietrucha, Katarzyna Stopyra
1Oddział Kardiologii i Chorób Wewnetrznych Szpital Specjalistyczny im. Ludwika Rydygiera w Krakowie. pstryjewski@o2.pl
Insights
Plasma renin activity (PRA) levels fluctuate in the early stages following ST-segment elevation myocardial infarction (STEMI), peaking between 5 days and 1 month. Initial PRA is notably higher in men than women after STEMI treated with primary PCI.
Area of Science:
- Cardiology
- Endocrinology
- Biochemistry
Context:
- Acute ST-segment elevation myocardial infarction (STEMI) is a critical cardiovascular event.
- Primary percutaneous coronary intervention (PCI) is a standard treatment for STEMI.
- The role of the renin-angiotensin-aldosterone system (RAAS) in post-MI recovery is of significant interest.
Purpose:
- To evaluate plasma renin activity (PRA) changes in patients with STEMI treated with primary PCI.
- To compare PRA levels between men and women post-STEMI.
- To investigate correlations between PRA and clinical/biochemical parameters.
Summary:
- PRA levels were monitored in 40 STEMI patients (30 men, 10 women) treated with primary PCI.
- PRA showed dynamic changes, peaking between 5 days and 1 month post-STEMI.
- Significantly higher PRA was observed in men compared to women on day 1 post-STEMI, with no significant differences thereafter.
- No significant correlations were found between PRA and age, BMI, NTproBNP, hsCRP, lipids, or left ventricular function.
Impact:
- This study highlights the temporal dynamics of PRA in the acute phase of STEMI.
- Findings suggest a potential sex-specific difference in early RAAS activation post-STEMI.
- Understanding PRA changes may offer insights into myocardial recovery and risk stratification.
Unlabelled:
The aim of this study was evaluation of plasma renin activity (PRA) in patients with acute ST-segement elevation myocardial infarction (STEMI) treated with primary percutaneous coronary interventions (PCI). We observed 40 patients (30 men, 10 woman) aged 29-69 yrs (mean age 53.9 SD 10.9) with first ST-segment elevation myocardial infarction. Patients were treated with primary percutaneous coronary intervention (PCI) with implantation of bare metal stent in the period up to 6 hours after the onset of chest pain. Plasma renin activity was evaluated on 1st, 3rd and 5th day and 1st and 3rd month after STEMI in all patients. Values of PRA were compared between men and women during a 3-month follow-up. Echocardiography examinations with left ventricular parameter measurements (included ventricular ejection fraction) were performed at 3rd day, 1st and 3rd month after STEMI. In all patients Troponin I level was measured in the first day of STEMI. In addition, the level of NTproBNP and hsCRP in plasma were measured in all patients at 1st day, 1st and 3rd month after STEMI. Changes of PRA levels within 3-months follow-up were evaluated in relation to the age, BMI, serum levels of NTproBNP, hsCRP, lipids and left ventricular function.
Results:
Median value of the PRA was 1.4 ng/ml/h at 1st day (N:1.46 +/- 0.23 ng/ml/h); 2.3 ng/ml/h at 3rd day; 3.9 ng/ml/h at 5th day; 2.1 ng/ml/h at 1 month, and 2.7 ng/ml/h at 3 months after STEMI. Peak value of PRA was observed between 5th day and 1st month after STEMI. PRA was significantly higher in men than in women at 1st day after STEMI (1.8 vs. 0.8 ng/ml/h; p = 0.002). There were no differences of PRA between men and women during the rest of the followup (3rd day - 3.3 vs. 2.0 ng/ml/h; 5th day 7.3 vs. 3.5 ng/ml/h; 1st month 4.1 vs. 2.1 ng/ml/h, 3rd month 3.5 vs. 2.2 ng/ml/h. There was no significant correlation between PRA and age, BMI, serum levels of NTproBNP, hsCRP, lipids and left ventricular function.
Conclusions:
1. Values of PRA change within early period after STEMI. The peak value was achieved between 5th day and 1st month after STEMI treated with primary PCI. 2. Plasma renin activity was significantly higher in men than in women at 1st day of STEMI treated with primary PCI.
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