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Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Significant association between admission serum monocyte chemoattractant protein-1 and early changes in myocardial
Yong Zhu1, Chengping Hu1, Yu Du1
1Department of cardiology, Beijing Anzhen Hospital, Capital Medical University, #2, Anzhenlu, Chaoyang District, Beijing, 100029, China.
Insights
High admission monocyte chemoattractant protein-1 (MCP-1) levels are linked to poorer early myocardial function recovery after ST-segment elevation myocardial infarction (STEMI). Lower MCP-1 is associated with improved left ventricular ejection fraction post-STEMI and primary PCI.
Area of Science:
- Cardiology
- Biochemistry
- Immunology
Background:
- Monocyte chemoattractant protein-1 (MCP-1) is implicated in ischaemic heart disease.
- The relationship between serum MCP-1 and early myocardial function changes post-STEMI following primary PCI was previously uninvestigated.
Purpose of the Study:
- To investigate the correlation between serum MCP-1 levels and early myocardial function changes in STEMI patients after primary PCI.
- To assess the impact of admission MCP-1 levels on myocardial recovery and cardiac biomarker levels.
Main Methods:
- 87 STEMI patients undergoing primary PCI were recruited.
- Patients were stratified into low and high MCP-1 groups based on admission levels.
- Left ventricular ejection fraction (LVEF) changes were measured from 2 days to 3 months post-STEMI.
Main Results:
- Admission MCP-1 positively correlated with hs-cTnI levels at multiple time points.
- The low admission MCP-1 group showed significantly improved early LVEF changes compared to the high MCP-1 group.
- Admission MCP-1 negatively correlated with early LVEF improvements, remaining significant after regression analysis.
Conclusions:
- Admission MCP-1 levels are inversely associated with early myocardial function improvement in STEMI patients.
- MCP-1 may be a potential therapeutic target for mitigating myocardial injury post-reperfusion.
Background:
Recent studies have indicated that monocyte chemoattractant protein-1 (MCP-1) plays an important role in the initiation and progression of ischaemic heart disease. However, no previous research has investigated the correlation between serum MCP-1 levels and early changes in myocardial function in patients with ST-segmental elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PCI).
Methods:
A total of 87 STEMI patients who had undergone a successful primary PCI were consecutively recruited. All the patients included in this study were grouped into two subgroups according to the median value of MCP-1 upon admission. An early change in left ventricular ejection fraction (LVEF) was defined as (LVEF at 3 months post-STEMI)-(LVEF at 2 days post-STEMI).
Results:
Serum MCP-1 levels increased gradually over time during the first 72 h after the onset of STEMI. The concentration of hypersensitive cardiac troponin I (hs-cTnI) upon admission as well as at 24 h and 72 h after primary PCI, especially the peak hs-cTnI concentration, declined significantly in the low admission MCP-1 group. As continuous variable, admission MCP-1 also correlated positively with admission hs-cTnI, hs-cTnI at 24 h after primary PCI, and peak hs-cTnI. Additionally, the absolute early change in LVEF improved markedly in the low admission MCP-1 group (3.77% ± 6.05% vs - 0.18% ± 7.69%, p = 0.009) compared to that in the high admission MCP-1 group. Most importantly, the global LVEF in the low admission MCP-1 group also improved significantly at 3 months compared to baseline LVEF (55.79% ± 7.05% vs 59.60% ± 6.51%, p = 0.011), while an improvement in global LVEF was not observed in the high admission MCP-1 group. Furthermore, as a continuous variable, the MCP-1 level up admission also correlated negatively with early changes in LVEF (r = - 0.391, p = 0.001). After assessment by multiple linear regression analysis, the MCP-1 level upon admission remained correlated with early changes in LVEF [beta = - 0.089, 95% CI (- 0.163 to - 0.015), p = 0.020].
Conclusion:
MCP-1 upon admission not only correlated positively with hs-cTnI at different time points and peak hs-cTnI, but also associated inversely with early improvements in myocardial function in patients with first STEMI. So we speculated that suppression the expression of MCP-1 via various ways may be a promising therapeutic target in myocardial I/R injury in the future.
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