Abstract 13947: Heparin-Mediated Release of Hepatocyte Growth Factor at the Acute Phase of STEMI

Abstract

Introduction: Hepatocyte Growth Factor (HGF) is a cytokine promoting cell survival via its receptor c-met. Heparin injection is known to induce a massive release of native HGF in blood. Heparin is used at the acute phase of myocardial infarction (MI). However, HGF release at the acute phase of MI and its potential cardioprotective effect is unknown. Hypothesis: We aimed to assess HGF kinetics in a cohort of ST-elevation myocardial infarction (STEMI) and its potential cardioprotective effect. Methods: We prospectively included consecutive STEMI patients admitted in our hospital from 2016 to 2019. All patients underwent coronary angiography with revascularization. Sera were collected at 5 time points (admission, 4 hours (H4), H24, H48 and 1 month after STEMI). Samples were stored at -80°C. HGF levels were assess by ELISA. We used a mouse model of myocardial ischemia reperfusion (ligation of the left anterior descending coronary artery followed by reperfusion) to evaluate HGF effect. Results: We included 230 patients. We observed an intense and early peak of HGF as early as admission, before revascularization (8750 pg/ml, IQR [8021-9492]) followed by a rapid decrease within the first 48h (p<0.0001). We demonstrated that this rapid increase was induced by heparin administration (unfractionated heparin or low molecular weight heparins). To evaluate the effect of HGF on myocardial infarct size we administrated HGF or placebo in mice during myocardial reperfusion. In the HGF group, infarct size was significantly smaller compared to the control group (52.0% of left ventricle vs 58.0%, p=0.002). Conclusions: We demonstrated an intense and early HGF peak at the acute phase of STEMI, induced by heparin. In our preclinical mouse model, HGF had cardioprotective effect after MI. Thus we may suppose that heparin-mediated release of HGF at the acute phase of STEMI have cardioprotective effect that may confer a basal cardioprotection in all patients.