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Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Association of Circulating Phenylacetylglutamine With Multi-Vessel Coronary Disease Severity and Outcomes in
Peng Zhao1,2,3, Nana Dong1,2,4, Yan Wang1,2,3,4
1Department of Cardiology The Second Affiliated Hospital of Harbin Medical University Harbin Province Heilongjiang China.
Insights
Plasma phenylacetylglutamine levels predict major adverse cardiovascular events (MACEs) in patients with ST-elevation myocardial infarction (STEMI) and multivessel coronary disease (MVCD). Higher levels indicate increased risk and lesion complexity, suggesting phenylacetylglutamine as a novel biomarker.
Area of Science:
- Cardiovascular Medicine
- Biomarker Discovery
- Clinical Prognosis
Background:
- Limited evidence exists on plasma phenylacetylglutamine and outcomes in ST-elevation myocardial infarction (STEMI) with multivessel coronary disease (MVCD).
- Assessing novel biomarkers for major adverse cardiovascular events (MACEs) in this high-risk population is crucial.
Purpose of the Study:
- To investigate the association between plasma phenylacetylglutamine levels and lesion severity.
- To evaluate phenylacetylglutamine as a predictive biomarker for MACEs in STEMI patients with MVCD.
Main Methods:
- Collected clinical data and plasma samples from 631 STEMI and MVCD patients undergoing primary percutaneous coronary intervention.
- Measured plasma phenylacetylglutamine using liquid chromatography-mass spectrometry.
- Analyzed lesion complexity and MACEs using quantitative coronary angiography, Kaplan-Meier curves, and Cox proportional hazard models.
Main Results:
- Higher plasma phenylacetylglutamine levels were significantly associated with increased MACEs.
- Elevated phenylacetylglutamine independently predicted MACEs (HR, 2.76).
- A novel prognostic score combining phenylacetylglutamine and PCI/CSS scores improved MACE risk prediction (HR, 4.01).
Conclusions:
- Plasma phenylacetylglutamine levels correlate with lesion complexity and prognosis in STEMI patients with MVCD.
- Phenylacetylglutamine shows potential as a novel predictive biomarker for MACEs in this cohort.
Background:
There is a lack of evidence regarding the association between plasma phenylacetylglutamine levels and lesion severity and clinical prognosis in patients with ST-segment elevation myocardial infarction (STEMI) with multivessel coronary disease (MVCD). This study aims to investigate the potential of phenylacetylglutamine as a biomarker for major adverse cardiovascular events (MACEs) of patients with STEMI and MVCD.
Methods And Results:
Clinical data and blood samples were collected from 631 patients with STEMI and MVCD, who underwent primary percutaneous coronary intervention. Quantitative coronary angiography analysis was performed using the QAngio XA 7.3 system. Plasma phenylacetylglutamine concentrations were measured by rapid resolution liquid chromatography quadrupole time-of-flight mass spectrometry. Among a total of 631 patients, median plasma phenylacetylglutamine level was 3.8 (2.1-6.8) μmol/L and the cumulative MACE rate at follow-up was 12%. Plasma phenylacetylglutamine levels of patients with MACE were significantly higher than patients without MACE. We employed restricted cubic spline, Kaplan-Meier curves, and Cox proportional hazard models to explore the association between plasma phenylacetylglutamine and prognosis of patients with STEMI and MVCD. Per SD, an increment in phenylacetylglutamine was associated with a 24% higher risk of complexity lesion. Higher phenylacetylglutamine level was an independent predictor of MACEs (hazard ratio [HR], 2.76 [95% CI, 1.62-4.72]). A novel prognostic scoring system was established by combining phenylacetylglutamine levels with the synergy between percutaneous coronary intervention with Taxus and cardiac surgery score, with higher scores significantly increasing the risk of MACEs (HR, 4.01 [95% CI, 2.04-7.89]).
Conclusions:
Phenylacetylglutamine levels were associated with lesion complexity and prognosis, may serve as a novel biomarker in patients with STEMI and MVCD.
