Prognostic impacts of Lipoxin A4 in patients with acute myocardial infarction: A prospective cohort study

Area of Science:

• Cardiovascular Medicine
• Lipid Mediators
• Inflammation Research

Background:

• Lipoxin A4 (LXA4), a specialized pro-resolving lipid mediator, is known to suppress atherosclerosis in preclinical models.
• However, its clinical significance in patients with established cardiovascular disease, particularly acute myocardial infarction (AMI), remains largely unelucidated.

Purpose of the Study:

• To investigate the prognostic value of plasma Lipoxin A4 (LXA4) levels in patients diagnosed with acute myocardial infarction (AMI).
• To determine the association between LXA4 levels and the occurrence of major adverse cardiovascular events (MACE) in this patient cohort.

Main Methods:

• Prospective recruitment of 1569 consecutive AMI patients from March 2017 to January 2020.
• Quantification of plasma LXA4 levels using enzyme-linked immunosorbent assay (ELISA).
• Assessment of major adverse cardiovascular events (MACE), including all-cause death, recurrent myocardial infarction, ischemic stroke, and revascularization, using Cox regression analysis, propensity score matching, and inverse probability weighting.

Main Results:

• The median plasma LXA4 level in AMI patients was 5.637 ng/mL.
• Elevated LXA4 levels (≥ 5.637 ng/mL) were significantly associated with a reduced risk of MACE (HR: 0.73, P=0.002), an association robust across multiple statistical analyses.
• Patients with high LXA4 and low high-sensitivity C-reactive protein (< 5.7 mg/L) exhibited the lowest MACE risk (HR: 0.68, P=0.012).

Conclusions:

• Higher plasma concentrations of Lipoxin A4 are linked to a decreased risk of recurrent ischemic events in patients following acute myocardial infarction.
• LXA4 demonstrates potential as a novel therapeutic target for mitigating cardiovascular inflammation and improving outcomes in AMI patients.