Niedokarboksylowane białko macierzy Gla u pacjentów z zawałem serca z uniesieniem odcinka ST oraz przewlekłymi zespołami wieńcowymi

Abstract

Introduction. Matrix Gla proteins (MGPs) are usually considered as natural inhibitors of soft tissue calcification in chronic inflammatory disorders. However, MGP levels in acute inflammation related to myocardial ischemia have been poorly investigated. This study aimed to compare the serum concentrations of uncarboxylated MGPs (ucMGPs) between patients with ST-segment elevation myocardial infarction (STEMI) vs. with chronic coronary syndromes (CCS) and to investigate the association between ucMGP concentration and an increased risk of major adverse cardiovascular events (MACE) in STEMI patients. Material and methods. 155 consecutive patients were enrolled (mean ± standard deviation age, 64 ± 13 years), including 80 patients with a first STEMI and 75 ones with CCS as controls. Blood samples were obtained within the first 24 h from hospital admission to evaluate ucMGP levels. Combination of MACE [all-cause mortality, heart failure (HF) within the first 30 days after myocardial infarction] was evaluated. Results. ucMGP levels were higher in patients with STEMI than in controls (2929 ± 96.5 ng/mL vs. 67.3 + 32.3 ng/mL; p < 0.0001). A significant positive correlation between ucMGP and high-sensitivity C-reactive protein, troponin levels was found. Multivariate analysis showed that ucMGP was an independent associate of STEMI [odds ratio (OR) 1.39; confidence interval (CI): 0.78–2.14, p = 0.01]. Although ucMGP did not predict the combined MACE, however it was an independent associate of HF occurrence 30 days after STEMI (OR, 1.20; 95% CI: 1.07–1.30, p = 0.04). Conclusion. Elevated ucMGP levels in patients with STEMI indicate that some MGPs may be involved in disorders related not only to chronic but also acute inflammatory states.