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Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Detection of biomarkers using a novel proximity extension assay in patients with ST-elevation myocardial infarction
Archana Kulasingam1, Anne-Mette Hvas2, Erik Lerkevang Grove3
1Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.
Insights
Biomarker levels change significantly after ST-elevation myocardial infarction (STEMI). Inflammation and clotting markers rise acutely, while tissue repair markers increase by three months, offering insights into STEMI pathogenesis.
Area of Science:
- Cardiovascular Medicine
- Biochemistry
- Biomarker Discovery
Background:
- ST-elevation myocardial infarction (STEMI) involves complex pathophysiological processes including inflammation, platelet activation, coagulation, fibrinolysis, and myocardial remodeling.
- Emerging proximity extension assays offer high-throughput analysis of numerous protein biomarkers for cardiovascular diseases.
Purpose of the Study:
- To investigate changes in a wide panel of cardiovascular protein biomarkers during the acute phase of STEMI compared to the stable phase three months post-STEMI.
- To test the hypothesis that major alterations in inflammation, hemostasis, tissue remodeling, and proteolysis are prevalent in STEMI.
Main Methods:
- Prospective observational study of 48 STEMI patients undergoing primary percutaneous coronary intervention (PPCI).
- Blood samples collected pre-PPCI and at three-month follow-up.
- Assessed 92 biomarkers using a proximity extension assay (Olink® CARDIOVASCULAR III) covering inflammation, immune response, cell adhesion, hemostasis, fibrinolysis, tissue remodeling, and proteolysis.
Main Results:
- A total of 29 biomarkers showed significant differences (p < 0.0005) between acute STEMI and the three-month stable phase.
- Biomarkers related to immune/inflammatory response, cell adhesion, and hemostasis were elevated in the acute phase.
- Biomarkers associated with tissue remodeling and proteolysis were increased at the three-month follow-up.
Conclusions:
- Novel proximity extension assays reveal significant dynamic changes in multiple biomarkers comparing acute STEMI to the stable phase.
- These identified biomarkers may hold critical roles in the underlying pathogenesis of STEMI.
Background:
ST-elevation myocardial infarction (STEMI) involves inflammation, activation of platelets, coagulation and changes in fibrinolysis as well as remodelling of myocardial tissue after STEMI. Recently, new proximity extension assays including panels of biomarkers for cardiovascular disease have been developed. This study investigates a wide range of cardiovascular protein biomarkers in the acute phase of STEMI compared with the stable phase three months after STEMI. We hypothesized that major changes in inflammation, haemostasis, tissue remodelling, and proteolysis are prevalent.
Materials And Methods:
This was a prospective, observational study including 48 STEMI patients (mean age 60 ± 12 years, 79% men) treated with primary percutaneous coronary intervention (PPCI). Blood samples were obtained immediately prior to PPCI and again three months later. Levels of 92 biomarkers reflecting inflammation, immune response, cell adhesion, haemostasis, fibrinolysis, tissue remodelling, and proteolysis were assessed using a proximity extension assay (Olink® CARDIOVASCULAR III).
Results:
When comparing the acute phase of STEMI with the stable phase three months later, a total of 29 biomarkers differed significantly after Bonferroni correction (p < 0.0005). In the acute phase of STEMI, we found an overall increase of biomarkers reflecting immune and inflammatory response, cell adhesion, and haemostasis. Biomarkers reflecting tissue remodelling and proteolysis were increased at three months follow-up compared with the acute phase. Out of the 29 biomarkers, six biomarkers did not confirm our predefined hypotheses.
Conclusions:
Using a novel proximity extension assay technique, we detected changes in several biomarkers when comparing the acute phase with three months follow-up in patients with STEMI. These biomarkers may play important roles in the pathogenesis of STEMI.
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