Amyloid β1-40 Predicts Long-Term Mortality Rate in Patients With Acute Myocardial Infarction.

Area of Science:

• Cardiovascular Medicine
• Biomarkers
• Atherosclerosis Research

Background:

• Amyloid β1-40 (Aβ1-40) is implicated in atherosclerosis, affecting plaque stability.
• The prognostic significance of Aβ1-40 in acute myocardial infarction (AMI) is primarily studied in non-ST-segment-elevation myocardial infarction (NSTEMI).

Purpose of the Study:

• To evaluate the prognostic value of Aβ1-40 in a real-world cohort of patients with AMI (both STEMI and NSTEMI).
• To identify predictors of elevated Aβ1-40 levels in this patient population.

Main Methods:

• Analysis of 1119 consecutive AMI patients (68% STEMI).
• Measurement of serum Aβ1-40 levels on admission.
• Kaplan-Meier and Cox multivariable analyses to assess mortality risk and Aβ1-40 as a predictor.
• Development of a nomogram to predict high Aβ1-40 levels.

Main Results:

• Median Aβ1-40 was 86.9 pg/mL, with no difference between STEMI and NSTEMI.
• Predictors of higher Aβ1-40 included older age, lower ejection fraction, higher HbA1c, and lower GFR.
• Elevated Aβ1-40 levels were associated with significantly higher all-cause mortality (HR 1.03, P=0.01) in the overall cohort.
• Aβ1-40 was an independent predictor of death in STEMI patients but not in NSTEMI patients.

Conclusions:

• Aβ1-40 serves as an independent predictor of mortality in patients with acute myocardial infarction.
• Aβ1-40 measurement can enhance risk stratification strategies for AMI patients.