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Related Experiment Videos

Lucia Ansani1, Jlenia Marchesini2, Gabriele Pestelli3

  • 1Operative Unit of Cardiology, University Hospital S. Anna of Ferrara, 44121 Ferrara, Italy. l.ansani@ospfe.it.

International Journal of Molecular Sciences
|September 19, 2018
PubMed
Summary

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Factor XIII A (FXIIIA) levels predict long-term outcomes after acute myocardial infarction (AMI). Genetically determined FXIIIA levels, particularly when sustained, identify patients needing targeted treatments for better prognosis.

Area of Science:

  • Cardiovascular Medicine
  • Genetics
  • Biochemistry

Background:

  • Factor XIIIA (FXIIIA) levels are established early prognostic markers for acute myocardial infarction (AMI).
  • The FXIIIA Valine-to-Leucine (V34L) polymorphism is linked to reduced AMI risk.
  • Long-term prognosis after AMI requires further investigation regarding FXIIIA's role.

Purpose of the Study:

  • To evaluate the long-term prognostic significance of FXIIIA levels and the V34L polymorphism in AMI patients.
  • To explore the association between FXIIIA levels, cardiovascular risk factors, and inherited genetic predispositions.
  • To identify predictors of major adverse cardiovascular events (MACE) over a five-year follow-up period.

Main Methods:

  • An observational study involving 333 AMI patients with a five-year follow-up.
Keywords:
coagulation factor XIIIleft ventricular remodeling and heart failuremyocardial healingmyocardial infarctionpharmacogeneticsprognostic biomarkerstranslation cardioprotective strategies

Related Experiment Videos

  • Genotyping of the FXIIIA V34L single nucleotide polymorphism (SNP).
  • Measurement of FXIIIA levels at day zero (d0) and day four (d4) post-AMI, alongside analysis of conventional risk factors and MACE development.

    • Main Results:

    • Both d0 and d4 FXIIIA levels independently predicted long-term MACE (FXIIIAd0 OR=3.02; FXIIIAd4 OR=4.46).
    • FXIIIAd4 demonstrated the strongest association with MACE, indicating a sustained protective effect.
    • FXIIIA levels stratified by V34L showed a lesser MACE prediction in L34 carriers, with V34L specifically predicting multiple MACE (p=0.0087).
    • Survival analysis revealed significant differences in heart failure and death versus stroke and recurrent ischemia (p=0.0013), with lower FXIIIA levels in the former group.

    Conclusions:

    • Genetically determined FXIIIA levels possess significant long-term prognostic value in AMI survivors.
    • Sustained high FXIIIA levels appear crucial for maximizing its protective role against MACE.
    • A pharmacogenetic approach targeting FXIIIA may aid in selecting high-risk AMI patients for tailored therapies.