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Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Increased plasma cathepsin S and trombospondin-1 in patients with acute ST-segment elevation myocardial infarction
Rahel Befekadu1, Kjeld Christiansen2, Anders Larsson3
1Department of Laboratory Medicine, Section for Transfusion Medicine, Faculty of Medicine and Health Örebro University, Örebro, Sweden. rshiferaw@hotmail.com.
Insights
Cathepsin S (Cat-S), not trombospondin-1 (TSP-1), may predict ST-segment elevation myocardial infarction (STEMI) severity. Cat-S levels remained elevated post-intervention, suggesting a potential role in long-term risk assessment for STEMI patients.
Area of Science:
- Cardiology
- Biomarker Research
- Vascular Biology
Background:
- Atherosclerosis and ischemic heart disease involve complex pathological processes.
- Platelet activation and specific biomarkers like trombospondin-1 (TSP-1) are implicated.
- Cathepsin S (Cat-S) is associated with increased mortality risk, independent of platelet activation.
Purpose of the Study:
- To investigate the role of TSP-1 and Cathepsin S (Cat-S) in patients with ST-segment elevation myocardial infarction (STEMI).
- To compare TSP-1 and Cat-S levels in relation to coronary vessel occlusion severity and percutaneous coronary intervention (PCI).
Main Methods:
- Analysis of plasma TSP-1 and Cat-S in STEMI patients (n=130) before, during, and after PCI.
- Stratification of patients based on coronary vessel occlusion: closed (n=90) vs. open (n=40).
- Comparison of biomarker levels with clinical outcomes and troponin-I levels.
Main Results:
- Plasma TSP-1 was elevated in acute STEMI with closed lesions, decreasing significantly post-PCI.
- Plasma Cat-S was elevated both pre- and post-PCI, with higher levels in patients with closed lesions 3 months post-PCI.
- No correlation was found between Cat-S, TSP-1, and troponin-I levels.
Conclusions:
- Cathepsin S (Cat-S), unlike TSP-1, may serve as a valuable biomarker for STEMI severity.
- Further research is needed to establish Cat-S as a predictor of long-term mortality in STEMI.
Background:
The role of cathepsins in the pathological progression of atherosclerotic lesions in ischem-ic heart disease have been defined in detail more than numerous times. This investigation examined the platelet-specific biomarker trombospondin-1 (TSP-1) and platelet function ex vivo, and compared this with cathepsin S (Cat-S; a biomarker unrelated to platelet activation but also associated this with increased mortality risk) in patients with ST-segment elevation myocardial infarction (STEMI).
Methods:
The STEMI patients were divided into two groups depending on the degree of coronary vessel occlusion: those with closed (n = 90) and open culprit vessel (n = 40). Cat-S and TSP-1 were analyzed before, 1-3 days after and 3 months after percutanous coronary intervention (PCI).
Results:
During acute STEMI, plasma TSP-1 was significantly elevated in patients with closed cul-prit lesions, but rapidly declined after PCI. In fact, TSP-1 after PCI was significantly lower inpatient samples compared to healthy individuals. In comparison, plasma Cat-S was significantly elevated both before and after PCI. In patients with closed culprit lesions, Cat-S was significantly higher compared to patients with open culprit lesions 3 months after PCI. Although troponin-I were higher (p < 0.01) in patients with closed culprit lesion, there was no correlation with Cat-S and TSP-1.
Conclusions:
Cat-S but not TSP-1 may be a useful risk biomarker in relation to the severity of STEMI. However, the causality of Cat-S as a predictor for long-term mortality in STEMI remains to be ascertained in future studies.
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