Blood level of alpha‐1 antitrypsin in the course of acute myocardial infarction patients: A possible clinical significance

Abstract

IntroductionWide experimental evidence has proved Alpha 1 antitrypsin, which is released from the liver, to protect lung tissue from damage during inflammation. There is experimental evidence also suggests such protection is extended to myocardial tissues during myocardial ischemia/infarction.ObjectiveThe aim of the study was to determine the levels and the time course of A1AT in the plasma of myocardial infarction patients over 96 hours and compare it with healthy subject as control.MethodsBlood samples were collected from patients (n=40) arriving at emergency department at 1, 4, 24, 48 and 96 hrs after diagnosis and admission to King Salman Cardiac Center, in King Fahad Medical City in Riyadh, Saudi Arabia. Blood samples were collected in purple top tubes containing EDTA to prevent blood coagulation. Blood plasma was separated by centrifugation with in 3 hrs of collection. Plasma was decanted and stored until analyzed. Alpha 1 antitrypsin was determined in all patients’ blood samples using human Eliza kits( abcam USA). In addition control blood samples were collected from 20 healthy individuals.ResultsA1AT levels were significantly less in MI patients (1025±77 ug/ml at 96 hrs, P<001) compared to (1655±128 ug/ml) (mean ± SEM) in controls. It was very interesting to find those patients win whom the decrease in A1AT was >50 % of control values, they did not survive and passed away (deceased) (673+71 ug/ml, n=3). Also the levels of A1AT after an MI attack was comparable and not significant in hypertensive compared to non‐hypertensive or in STEMI and Non‐STEMI patients but was significantly (P<0.03) higher in non‐smokers (1457+163, n=27) compared to smokers (1153±155, n=10).ConclusionThe plasma level of A1AT is suggested to be important in providing some protection to myocardial cells during an MI attack. A1AT levels seem to drop shortly following an MI attack. The drop in the level is larger in smokers. In those patients in whom the level of A1AT drops to more about 50 % of normal values they are less likely to survive the MI attack. More studies are needed to confirm the above findings.Support or Funding InformationWe acknowledge the financial support from the research center at King Fahad Medical City, Riyadh, Saudi ArabiaFigure 1Figure 2