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Published on: January 28, 2020
Factors of Long-Term Prognosis for Cardiovascular Complications in Patients After Acute Myocardial Infarction, Based
E L Kordzaya1, A S Kononikhin2, E N Nikolaev2
1Davydovsky Municipal Clinical Hospital.
Insights
This study identified four plasma proteins—apolipoprotein C1, complement factor H, di-N-acetylchitobiase, and ficolin-2—as reliable predictors of long-term cardiovascular complications in patients with acute myocardial infarction (AMI). These markers aid in assessing prognosis and guiding patient management.
Area of Science:
- Cardiovascular Research
- Proteomics
- Biomarker Discovery
Background:
- Type 1 acute myocardial infarction (AMI) poses significant long-term cardiovascular risks.
- Identifying reliable prognostic markers for AMI patients is crucial for effective risk stratification and management.
- Current prognostic tools may require enhancement for improved long-term prediction accuracy.
Purpose of the Study:
- To investigate the plasma proteome of type 1 AMI patients.
- To identify potential protein biomarkers for predicting long-term cardiovascular complications.
- To develop a prognostic model for assessing unfavorable outcomes in AMI survivors.
Main Methods:
- Plasma proteome analysis using chromatography-mass spectrometry in 64 type 1 AMI patients.
- 36-month follow-up for major adverse cardiovascular events (MACE).
- Statistical analyses including multivariate regression, ROC curves, and Kaplan-Meier models.
Main Results:
- Cardiovascular complications occurred in 36% of patients within 36 months.
- Seven differentially expressed proteins were identified between prognosis groups.
- Apolipoprotein C1, complement factor H, di-N-acetylchitobiase, and ficolin-2 were significant predictors of long-term risk.
- An integrated prognostic model demonstrated 87% sensitivity and 78% specificity.
Conclusions:
- Plasma levels of apolipoprotein C1, complement factor H, di-N-acetylchitobiase, and ficolin-2 are robust prognostic markers for AMI.
- These proteins can reliably assess long-term cardiovascular event risk in AMI patients.
- The developed integrated parameter offers a valuable tool for long-term prognosis assessment.
Aim:
To study the plasma proteome of patients with type 1 acute myocardial infarction (AMI) to identify potential markers for long-term prognosis of the risk for developing cardiovascular complications.
Material And Methods:
The study included 64 patients with type 1 AMI with and without ST segment elevation who underwent primary percutaneous coronary intervention upon admission. The following information on cardiovascular events was collected for 36 months after admission: death from cardiovascular pathology, recurrent AMI, stroke, repeat myocardial revascularization and/or endarterectomy. Peripheral blood sampling followed by a plasma proteome analysis using chromatography-mass spectrometry was performed in all patients before hospitalization.
Results:
During 36 months after hospitalization, cardiovascular complications were detected in 23 (36%) patients. These patients were included in the group with an unfavorable prognosis, while the remaining patients made up the group with a positive prognosis. A mass spectrometric analysis of the plasma proteome and comparison of the groups identified seven differentially represented proteins. Also, a multivariate regression analysis, ROC curves, and Kaplan-Meier models showed that four proteins (apolipoprotein C1, complement factor H, di-N-acetylchitobiase, and ficolin-2) were predictors of the risk for developing cardiovascular complications in the long term. An integrated parameter was developed that took into account the plasma concentrations of all four above proteins. This parameter was used to construct a model for assessing the risks of unfavorable long-term prognosis in AMI patients with a sensitivity of 87% and a specificity of 78%.
Conclusion:
The study results demonstrated that plasma concentrations of apolipoprotein C1, complement factor H, di-N-acetylchitobiase, and ficolin-2 are reliable prognostic markers for assessing the risks of cardiovascular events in patients with AMI in the long term.
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