Internal Medicine Department, State Medical University, Ministry of Health of Ukraine, Zaporozhye 69035, Ukraine.
Internal Medicine Department, Medical Academy of Post-Graduate Education, Ministry of Health of Ukraine, Zaporozhye 69096, Ukraine.
Dis Markers. 2020 Jun 12;2020:1215802. doi: 10.1155/2020/1215802. eCollection 2020.
The prevalence of heart failure (HF) due to cardiac remodelling after acute myocardial infarction (AMI) does not decrease regardless of implementation of new technologies supporting opening culprit coronary artery and solving of ischemia-relating stenosis with primary percutaneous coronary intervention (PCI). Numerous studies have examined the diagnostic and prognostic potencies of circulating cardiac biomarkers in acute coronary syndrome/AMI and heart failure after AMI, and even fewer have depicted the utility of biomarkers in AMI patients undergoing primary PCI. Although complete revascularization at early period of acute coronary syndrome/AMI is an established factor for improved short-term and long-term prognosis and lowered risk of cardiovascular (CV) complications, late adverse cardiac remodelling may be a major risk factor for one-year mortality and postponded heart failure manifestation after PCI with subsequent blood flow resolving in culprit coronary artery. The aim of the review was to focus an attention on circulating biomarker as a promising tool to stratify AMI patients at high risk of poor cardiac recovery and developing HF after successful PCI. The main consideration affects biomarkers of inflammation, biomechanical myocardial stress, cardiac injury and necrosis, fibrosis, endothelial dysfunction, and vascular reparation. Clinical utilities and predictive modalities of natriuretic peptides, cardiac troponins, galectin 3, soluble suppressor tumorogenicity-2, high-sensitive C-reactive protein, growth differential factor-15, midregional proadrenomedullin, noncoding RNAs, and other biomarkers for adverse cardiac remodelling are discussed in the review.
尽管新的技术支持开通罪犯冠状动脉并解决原发性经皮冠状动脉介入治疗(PCI)相关的狭窄,但急性心肌梗死(AMI)后心脏重构导致的心力衰竭(HF)的患病率并未降低。许多研究已经检查了循环心脏生物标志物在急性冠状动脉综合征/AMI 和 AMI 后心力衰竭中的诊断和预后能力,而描述生物标志物在接受原发性 PCI 的 AMI 患者中的应用的研究则更少。虽然急性冠状动脉综合征/AMI 早期的完全血运重建是改善短期和长期预后以及降低心血管(CV)并发症风险的既定因素,但晚期不良心脏重构可能是一年死亡率的主要危险因素,也是 PCI 后血流解决罪犯冠状动脉后延迟出现心力衰竭的表现的主要危险因素。本综述的目的是关注循环生物标志物作为一种有前途的工具,用于对 AMI 患者进行分层,这些患者具有不良心脏恢复和成功 PCI 后发生 HF 的高风险。主要考虑的是炎症、心肌生物力学应激、心肌损伤和坏死、纤维化、内皮功能障碍和血管修复的生物标志物。本综述讨论了利钠肽、心脏肌钙蛋白、半乳糖凝集素 3、可溶性肿瘤抑制物-2、高敏 C 反应蛋白、生长差异因子-15、中区域前肾上腺髓质素、非编码 RNA 和其他用于不良心脏重构的生物标志物的临床应用和预测模式。