Abstract

BackgroundPeriostin was proved to play an important role in extra-cellular matrix remodeling after acute myocardial infarction (AMI). Myocardial periostin was markedly up-regulated after AMI and participated in the maladaptive process of cardiac remodeling. However, few researches focused on the circulating periostin and its significance. This study aims to investigate the association of serum periostin level with cardiac function and short-term prognosis in AMI patients.Methodology/Principal FindingsWe totally recruited 50 patients diagnosed as ST-elevation myocardial infarction. Blood samples were taken within 12 hours after the onset of AMI before emergency coronary revascularization procedures. Serum periostin was measured using enzyme-linked immunosorbent assay. All patients received echocardiography examination within one week after hospitalization. Correlations of serum periostin with echocardiography parameters, Killip class and myocardium injury biomarkers (CK-MB/troponin T) were investigated. AMI patients were divided into two groups by serum periostin level (higher/lower periostin group) and followed up for six months. Primary endpoints included cardiovascular mortality, nonfatal stroke/transient ischemic attack, chest pain occurrence and re-hospitalization. Secondary endpoint referred to composite cardiovascular events including all the primary endpoints.ResultSerum periostin was in negative association with left ventricular ejection fraction (LVEF) (r = −0.472, *p<0.01) and left atrium diameter (LAD) (r = −0.328, *p<0.05). Positive correlation was found between serum periostin level and Killip class (r = 0.395, *p<0.01). There was no association between serum periostin and CK-MB or troponin T (p>0.05). After six months follow up, patients in higher periostin group showed increased composite cardiovascular events (*p<0.05). Patients showed no significant difference in primary endpoints between the two groups.Conclusions/SignificanceSerum periostin was in negative correlation with LVEF and LAD, in positive association with Killip class and higher serum periostin level may be predictive for worse short-term disease prognosis indicated as more composite cardiovascular events six months post AMI.

Highlights

  • Acute myocardial infarction (AMI) remains as a worldwide public health problem with an increasing rate of incidence and causes irreversible cardiomyocytes impairment [1]

  • Periostin was a 90-kDa extra-cellular matrix protein secreted by fibroblasts, which acted as an important regulator in ventricular remodeling process such as pathological hypertrophy or fibrosis after myocardial injury

  • Coronary and echocardiography parameters as well as myocardium injury biomarkers were assessed in acute myocardial infarction (AMI) patients and their relationship with serum periostin level were analyzed

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Summary

Introduction

Acute myocardial infarction (AMI) remains as a worldwide public health problem with an increasing rate of incidence and causes irreversible cardiomyocytes impairment [1]. Activation of myocardial fibroblasts through both stretch-related signaling and neuron-endocrine effectors led to the secretion of various ECM proteins These proteins conducted molecular signals, regulated cell kinetics and altered the structure of extra-cellular matrix [3,4]. Periostin was a 90-kDa extra-cellular matrix protein secreted by fibroblasts, which acted as an important regulator in ventricular remodeling process such as pathological hypertrophy or fibrosis after myocardial injury. Inhibition the expression of periostin was able to improve cardiac systolic ejection function and animal survival rate [8]. These researches demonstrated a detrimental effect of periostin in cardiovascular system. Periostin was proved to play an important role in extra-cellular matrix remodeling after acute myocardial infarction (AMI). This study aims to investigate the association of serum periostin level with cardiac function and short-term prognosis in AMI patients

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