Free fatty acids as a marker for predicting periprocedural myocardial injury after coronary intervention

Area of Science:

• Cardiology
• Biochemistry

Background:

• Plasma free fatty acids (FFAs) are linked to cardiovascular risk.
• The predictive role of FFAs for periprocedural myocardial injury (PMI) after percutaneous coronary intervention (PCI) in stable coronary artery disease (CAD) is not well-established.

Purpose of the Study:

• To investigate the association between preprocedural free fatty acid (FFA) levels and periprocedural myocardial injury (PMI) in patients with coronary artery disease (CAD) undergoing PCI.
• Focus on patients with CAD not receiving lipid-lowering therapy and normal baseline cardiac troponin I (cTnI).

Main Methods:

• Prospective enrollment of 374 consecutive patients with CAD, no prior lipid-lowering treatment, and normal preprocedural cTnI undergoing PCI.
• Collection of baseline characteristics and assessment of PMI via cTnI levels within 24 hours post-PCI.
• Analysis of the correlation between preprocedural FFA levels and peak post-PCI cTnI values.

Main Results:

• Preprocedural FFAs showed a positive correlation with peak post-PCI cTnI in both simple (β=0.119, p=0.021) and multiple regression models (β=0.198, p=0.001).
• Patients with higher FFA levels exhibited significantly higher postprocedural cTnI levels (0.66±0.31 ng/mL vs 0.27±0.68 ng/mL, p=0.014).
• Multivariable analysis indicated that elevated preprocedural FFA levels were associated with an increased risk of postprocedural cTnI elevation (OR: 1.185 to 1.132, p<0.05).

Conclusions:

• This study provides initial evidence that elevated free fatty acid (FFA) levels are associated with an increased risk of periprocedural myocardial injury (PMI) in untreated patients with coronary artery disease (CAD).
• Further large-scale studies are warranted to validate these findings and their clinical implications.