Macrophage migration inhibitory factor for the early prediction of infarct size
William Chan1, David A White, Xin-Yu Wang
1Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Australia.
Background:
Early diagnosis and knowledge of infarct size is critical for the management of acute myocardial infarction (MI). We evaluated whether early elevated plasma level of macrophage migration inhibitory factor (MIF) is useful for these purposes in patients with ST-elevation MI (STEMI).
Methods And Results:
We first studied MIF level in plasma and the myocardium in mice and determined infarct size. MI for 15 or 60 minutes resulted in 2.5-fold increase over control values in plasma MIF levels while MIF content in the ischemic myocardium reduced by 50% and plasma MIF levels correlated with myocardium-at-risk and infarct size at both time-points (P < 0.01). In patients with STEMI, we obtained admission plasma samples and measured MIF, conventional troponins (TnI, TnT), high sensitive TnI (hsTnI), creatine kinase (CK), CK-MB, and myoglobin. Infarct size was assessed by cardiac magnetic resonance (CMR) imaging. Patients with chronic stable angina and healthy volunteers were studied as controls. Of 374 STEMI patients, 68% had elevated admission MIF levels above the highest value in healthy controls (> 41.6 ng/mL), a proportion similar to hsTnI (75%) and TnI (50%), but greater than other biomarkers studied (20% to 31%, all P < 0.05 versus MIF). Only admission MIF levels correlated with CMR-derived infarct size, ventricular volumes and ejection fraction (n = 42, r = 0.46 to 0.77, all P < 0.01) at 3 day and 3 months post-MI.
Conclusion:
Plasma MIF levels are elevated in a high proportion of STEMI patients at the first obtainable sample and these levels are predictive of final infarct size and the extent of cardiac remodeling.
Insights
Early detection of macrophage migration inhibitory factor (MIF) in ST-elevation myocardial infarction (STEMI) patients predicts infarct size and cardiac remodeling, aiding in acute myocardial infarction management.
Area of Science:
- Cardiology
- Biomarker Discovery
- Immunology
Background:
- Early diagnosis and infarct size assessment are crucial for managing acute myocardial infarction (MI).
- Macrophage migration inhibitory factor (MIF) is a potential biomarker for MI.
- This study investigates the utility of plasma MIF levels in ST-elevation MI (STEMI).
Purpose of the Study:
- To evaluate early plasma MIF levels as a diagnostic and prognostic marker in STEMI patients.
- To correlate MIF levels with infarct size and cardiac remodeling.
- To compare MIF with conventional cardiac biomarkers.
Main Methods:
- MIF levels and infarct size were assessed in mice post-MI.
- Admission plasma samples from 374 STEMI patients were analyzed for MIF and other biomarkers (troponins, CK-MB, myoglobin).
- Infarct size and cardiac remodeling were evaluated using cardiac magnetic resonance (CMR) imaging at 3 days and 3 months post-MI.
Main Results:
- In mice, plasma MIF increased significantly post-MI, correlating with infarct size.
- In STEMI patients, 68% had elevated admission MIF levels, a proportion comparable to hsTnI.
- Admission MIF levels, unlike other biomarkers, strongly correlated with CMR-derived infarct size, ventricular volumes, and ejection fraction at both follow-up points.
Conclusions:
- Elevated plasma MIF levels are common in STEMI patients upon admission.
- Early plasma MIF levels are predictive of final infarct size.
- MIF levels correlate with long-term cardiac remodeling and adverse outcomes post-STEMI.
