Abstract 12466: Assessment of Extracellular Matrix Remodeling Biomarkers Shortly After Admission for ST-Elevated Myocardial Infarction

Abstract

Introduction: ST-elevated myocardial infarction (STEMI) is followed by changes in the extracellular matrix (ECM) composition. ECM protein fragments are released into the bloodstream and can be targeted as biomarkers. We aimed at investigating the prognostic ability of ECM biomarkers in STEMI patients. Methods: Biomarkers of collagens type I, III, IV degradation (C1M, C3M, C4M, respectively) and collagen type VI formation (PRO-C6) were measured by specific enzyme-linked immunosorbent assays in plasma of 221 patients admitted with STEMI. Plasma was collected at two timepoints, at admission and 6-12 hours post-admission. The prognostic ability of the biomarkers was evaluated via Cox-proportional hazard regression analyses using all-cause mortality at 1 year as outcome. Results: The plasma concentration of all biomarkers significantly increased (15.5-28.4%) from admission to 6-12 hours post-admission (p<0.0001). All biomarkers were prognostic for all-cause mortality within the first year after STEMI, after adjustment for potential risk factors (age, BMI, sex, blood pressure and smoking status) (Table 1). When applying a forward hazard regression analysis including the risk factors and the four ECM biomarkers at admission, PRO-C6 and C1M remained significantly associated with all-cause mortality at 1 year (C1M: HR=1.02, p-value=0.004, PRO-C6: HR=1.08, p-value=0.03). While after 6-12 hours, only C1M remained significantly associated (C1M: HR=1.04, p-value<0.0001). Conclusions: Biomarkers reflecting degradation of collagens type I, III and IV, and formation of collagen type VI, were significantly altered shortly after admission for STEMI. PRO-C6 and C1M demonstrated an independent prognostic ability of risk of all-cause mortality within the first year after a STEMI event.