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首次急性心肌梗死患者中八种循环生物标志物的时间轨迹与左心室射血分数的关联:一项为期12个月的前瞻性队列研究。

Temporal trajectory and left ventricular ejection fraction association of eight circulating biomarkers in first acute myocardial infarction patients: a 12-month prospective cohort study.

作者信息

Elbaz Meyer, Grazide Marie-Hélène, Bataille Vincent, Blanc Grégoire, Cantero Anne-Valérie, Firat Hueseyin, Vindis Cécile

机构信息

Center for Clinical Investigation (CIC1436)/CARDIOMET, Rangueil University Hospital, Toulouse 31400, France.

University of Toulouse III, Toulouse 31400, France.

出版信息

Eur Heart J Open. 2024 Oct 15;4(5):oeae090. doi: 10.1093/ehjopen/oeae090. eCollection 2024 Sep.

Abstract

AIMS

Our study aimed to explore the temporal trajectory of eight circulating biomarkers, measured serially over 12 months, in a prospective observational cohort of patients with acute myocardial infarction (AMI) and to investigate the association between these biomarkers and left ventricular ejection fraction (LVEF) during follow-up assessments.

METHODS AND RESULTS

We enrolled 155 patients admitted for a first AMI requiring percutaneous coronary intervention (PCI). Baseline characteristics, laboratory test results, and cardiac ultrasound examinations were collected at pre-PCI (H0), immediately post-PCI (H24), at discharge (D3), and at 6 months (M6) and 12 months (M12) post-PCI. Blood samples were analysed for established and emerging biomarkers described in left ventricular dysfunction: soluble suppression of tumorigenicity 2 (sST2), interleukin-6 (IL-6), osteopontin, angiopoietin-2, insulin-like growth factor-binding protein 2 (IGFBP-2), growth differentiation factor 15 (GDF-15), hepcidin, and galectin-3. Values at H24, D3, M6, and M12 were compared with value at H0. Three kinetic profiles were identified, with six biomarkers peaking during the acute MI phase. Crude relationships between clinical variables and the peak values (highest observed between H0 and D3) of each biomarker were studied. Peak levels of sST2, IL-6, osteopontin, and angiopoietin-2 demonstrated significant correlations with both baseline and follow-up LVEF values.

CONCLUSION

The assessment of the temporal trajectories of these biomarkers and their associations with LVEF suggests that sST2, IL-6, osteopontin, and angiopoietin-2 hold significant promise as companion biomarkers. These biomarkers may improve the identification of patients at risk for developing impaired LVEF following AMI, thereby enabling more targeted and effective management strategies.

摘要

目的

我们的研究旨在探讨在急性心肌梗死(AMI)患者的前瞻性观察队列中,连续12个月测量的八种循环生物标志物的时间轨迹,并在随访评估期间研究这些生物标志物与左心室射血分数(LVEF)之间的关联。

方法与结果

我们纳入了155例因首次AMI需要进行经皮冠状动脉介入治疗(PCI)而入院的患者。在PCI术前(H0)、PCI术后即刻(H24)、出院时(D3)以及PCI术后6个月(M6)和12个月(M12)收集基线特征、实验室检查结果和心脏超声检查数据。对血液样本进行分析,检测左心室功能障碍中已确定和新出现的生物标志物:可溶性肿瘤抑制因子2(sST2)、白细胞介素-6(IL-6)、骨桥蛋白、血管生成素-2、胰岛素样生长因子结合蛋白2(IGFBP-2)、生长分化因子15(GDF-15)、铁调素和半乳糖凝集素-3。将H24、D3、M6和M12时的值与H0时的值进行比较。确定了三种动力学曲线,六种生物标志物在急性心肌梗死阶段达到峰值。研究了临床变量与每种生物标志物峰值(H0和D3之间观察到的最高值)之间的粗略关系。sST2、IL-6、骨桥蛋白和血管生成素-2的峰值水平与基线和随访LVEF值均显示出显著相关性。

结论

对这些生物标志物的时间轨迹及其与LVEF的关联进行评估表明,sST2、IL-6、骨桥蛋白和血管生成素-2作为伴随生物标志物具有很大的前景。这些生物标志物可能有助于改善对AMI后发生LVEF受损风险患者的识别,从而实现更有针对性和有效的管理策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e20e/11521257/054bdba81ecb/oeae090_ga.jpg

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