Higher plasma secretoneurin levels 24h after STEMI independently predicted increased risk of major adverse cardiovascular events (OR 1.03, p<0.001).
Are higher plasma secretoneurin levels associated with major adverse cardiovascular events in STEMI patients revascularized by primary PCI?
Higher plasma levels of secretoneurin measured 24 hours after STEMI are independently associated with an increased risk of major adverse cardiovascular events at 12 months, suggesting its potential as a prognostic biomarker.
Tasa de eventos absoluta: 0% vs 0%
Abstract Background Acute myocardial infarction is associated with the release of a variety of peptides, including neuropeptides. Recently, upregulation of secretogranin II, the precursor molecule of the neuropeptide secretoneurin (SN), and beneficial effects of SN have been observed in experimental rodent models of myocardial infarction. In addition, antiarrhythmic effects have been attributed to SN. Based on these data, we investigated the role of plasma SN levels in STEMI patients revascularized by primary percutaneous coronary intervention (PCI). Methods In this observational study, we included 237 STEMI patients enrolled in the prospective MARINA-STEMI study. Plasma SN concentrations were measured by immunoassay 24 h after PCI from peripheral venous blood samples. Cardiac magnetic resonance (CMR) imaging was used to determine left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), infarct size (IS) and microvascular obstruction (MVO). Major adverse cardiovascular event (MACE) defined as all-cause death, myocardial reinfarction and new congestive heart failure was assessed at 12 months. Results Median plasma concentrations of SN were 78 interquartile range (IQR): 71-90 pg/ml. Patients with SN concentrations above median were significantly older (59 IQR: 53-70 vs. 54 49-61 years, p0.001). SN concentrations were not significantly associated with IS, MVO, LVEF or GLS (all p0.05). In multivariable cox-regression SN was significantly and independently associated with MACE after adjustment for univariable associates including age, high-sensitivity cardiac troponin-T and N-terminal pro-B-type natriuretic peptide at 24 hours (Model A: OR 1.02 95% confidence interval 1.00-1.04, p=0.020) or CMR data including MVO and LVEF (Model B: OR 1.03 95% confidence interval: 1.01-1.05, p0.001). The predictive value of SN for new congestive heart failure was strong with an area under the curve of 0.75. Conclusion Higher plasma levels of SN measured 24 h after STEMI were independently associated with adverse clinical outcome as shown by higher rates of major adverse cardiovascular events. No association was observed with CMR parameters such as IS, MVO, LVEF or GLS. SN may be a promising biomarker for risk prediction in STEMI patients.
Theurl et al. (Sat,) reported a other. Higher plasma secretoneurin levels 24h after STEMI independently predicted increased risk of major adverse cardiovascular events (OR 1.03, p<0.001).