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PROGNOSTICATION OF CLINICAL OUTCOMES AFTER STEMI: THE ROLE OF VASCULAR ENDOTHELIAL GROWTH FACTOR-A.

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Low Vascular Endothelial Growth Factor-A (VEGF-A) levels after ST-segment elevation myocardial infarction (STEMI) predict recurrent cardiac events and post-infarction angina. Anxiety and depression contribute to decreased VEGF-A, indicating impaired neovascularization.

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Area of Science:

  • Cardiovascular Medicine
  • Molecular Biology
  • Regenerative Medicine

Background:

  • Vascular Endothelial Growth Factor-A (VEGF-A) is crucial for angiogenesis, the formation of new blood vessels.
  • Myocardial infarction (MI) involves damage to the heart muscle due to blocked blood flow.
  • Assessing prognostic markers after MI is vital for patient outcomes and preventing complications like angina.

Purpose of the Study:

  • To evaluate the prognostic role of VEGF-A in patients following ST-segment elevation myocardial infarction (STEMI).
  • To determine if VEGF-A levels can predict recurrent coronary events and post-infarction angina.
  • To investigate the association between psychological factors (anxiety, depression) and VEGF-A levels post-STEMI.

Main Methods:

  • Enrolled 62 STEMI patients and 12 controls.
  • Measured serum VEGF levels using enzyme-linked immunosorbent assay (ELISA) on day 7 post-STEMI.
  • Assessed angina development over a 6-month follow-up period.
  • Utilized Receiver Operating Characteristic (ROC) analysis and multivariate logistic regression.

Main Results:

  • A VEGF-A cut-off level of ≤172.4 pg/ml on day 7 predicted recurrent coronary events (AUC 0.697, P=0.0515).
  • Anxiety (OR 0.834, P=0.0107) and depression (OR 0.741, P=0.0519) were associated with decreased VEGF-A levels.
  • Lower VEGF-A levels correlated with impaired myocardial neovascularization and increased risk of post-infarction angina.

Conclusions:

  • Serum VEGF-A levels on day 7 post-STEMI serve as a significant predictor of adverse cardiac outcomes.
  • Psychological distress, specifically anxiety and depression, negatively impacts VEGF-A levels, hindering cardiac repair.
  • Targeting VEGF-A and addressing mental health may improve prognosis and reduce angina in STEMI survivors.