Abstract
Macrophage migration inhibitory factor (MIF), a widely expressed pleiotropic cytokine, is reportedly involved in several cardiovascular diseases, in addition to inflammatory diseases. Plasma MIF levels are elevated in the early phase of acute cardiac infarction. This study is aimed at investigating the correlation between plasma MIF levels and cardiac function and prognosis in patients with acute ST-segment elevation myocardial infarction (STEMI) with or without diabetes mellitus. Overall, 204 patients with STEMI who underwent emergency percutaneous coronary intervention were enrolled: 57 and 147 patients in the diabetes and nondiabetes STEMI groups, respectively. Sixty-five healthy people were selected as controls. Plasma MIF levels were measured at the time of diagnosis. Basic clinical data and echocardiographic findings within 72 h of admission were collected. Patients were followed up, and echocardiograms were reviewed at the 12-month follow-up. Plasma MIF levels were significantly higher in the diabetes and nondiabetes STEMI groups than in the control group and in patients with Killip grade ≥ II STEMI than in those with Killip grade I. Plasma MIF levels were negatively correlated with the left ventricular ejection fraction (LVEF) of myocardial infarction in patients with or without diabetes in the acute phase of infarction, whereas the left ventricular diastolic dysfunction (LVDD) was positively correlated. MIF levels in the nondiabetes STEMI group were positively correlated with N-terminal pro-b-type natriuretic peptide levels and were associated with LVEF and LVDD at the 12-month follow-up. The risk of adverse cardiovascular and cerebrovascular events was significantly higher in the MIF high-level group (≥52.7 ng/mL) than in the nondiabetes STEMI group 36 months after presentation. Thus, MIF levels in STEMI patients with or without diabetes can reflect acute cardiac function. In STEMI patients without diabetes, MIF levels can also indicate cardiac function and long-term prognosis at the 12-month follow-up.
Highlights
White blood cell counts and hypersensitive C-reactive protein (hs-CRP) and low-density lipopolysaccharide cholesterol (LDL-c) levels were significantly higher in the diabetes and nondiabetes segment elevation myocardial infarction (STEMI) groups than in the control group
Coronary angiography indicated that the proportion of patients with multivessel disease was higher in the diabetes STEMI group than in the nondiabetes STEMI group (45.6% vs. 32.0%, P = 0 049)
We found that plasma migration inhibitory factor (MIF) levels in patients with diabetes mellitus and nondiabetes STEMI could reflect the extent of impaired cardiac function in the acute phase, probably because MIF levels in the early stage of infarction could reflect the myocardial infarct size indicated by myocardial zymogram changes and imaging [3, 7] and the size of myocardial infarction is one of the main factors that affected acute cardiac function impairment after myocardial infarction
Summary
Acute myocardial infarction is a clinically critical disease with increasing incidence, and its long-term prognosis is significantly associated with infarction-induced heart failure [1]. Acute and long-term outcomes have significantly improved with the development of coronary interventions, aggressive anticoagulation, and antiplatelet therapy. There have still been higher recurrent major adverse cardiovascular events in some patient populations, especially acute myocardial infarction in type 2 diabetes mellitus patients. Diabetes mellitus is associated with a markedly increased risk for cardiovascular diseases and death, which was univocally confirmed by results from the Whitehall study [2]. Identifying biomarkers that are elevated in early-stage acute myocardial infarction complicated with diabetes and that have a certain suggestive effect on cardiac function after infarction is necessary
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