Abstract
BackgroundSince post-infarction heart failure (HF) determines a great morbidity and mortality, and given the physiopathology implications of advanced glycation end products (AGE) in the genesis of myocardial dysfunction, it was intended to analyze the prognostic value of these molecules in order to predict post-infarction HF development.MethodsA prospective clinical study in patients after first acute coronary syndrome was conducted. The follow-up period was consisted in 1 year. In 194 patients consecutively admitted in the coronary unit for myocardial infarct fluorescent AGE levels were measured. The association between glycaemic parameters and the development of post-infarction HF were analyzed in those patients. Finally, we identified the variables with independent predictor value by performing a multivariate analysis of Hazard ratio for Cox regression.ResultsEleven out of 194 patients (5.6%) developed HF during follow-up (median: 1.0 years [0.8 - 1.5 years]). Even though basal glucose, fructosamine and glycated haemoglobin were significant predictive factors in the univariate analysis, after being adjusted by confounding variables and AGE they lost their statistical signification. Only AGE (Hazard Ratio 1.016, IC 95%: 1.006-1.026; p<0,001), together with NT-proBNP and the infarct extension were predictors for post-infarction HF development, where AGE levels over the median value 5-fold increased the risk of HF development during follow-up.ConclusionsAGE are an independent marker of post-infarction HF development risk.
Highlights
Since post-infarction heart failure (HF) determines a great morbidity and mortality, and given the physiopathology implications of advanced glycation end products (AGE) in the genesis of myocardial dysfunction, it was intended to analyze the prognostic value of these molecules in order to predict post-infarction HF development
Recent studies have shown the implication of hyperglycaemia in the development of HF [6], establishing an independent prognostic value for glycated haemoglobin (HbA1c) predicting the risk of HF in both diabetic and non-diabetic patients [7,8]
Study population This is a prospective single centre study including all consecutive patients admitted with acute myocardial infarction in the coronary care unit from our hospital between October 2009 and January 2011, and who had survived to the acute coronary event during the hospital stay
Summary
Since post-infarction heart failure (HF) determines a great morbidity and mortality, and given the physiopathology implications of advanced glycation end products (AGE) in the genesis of myocardial dysfunction, it was intended to analyze the prognostic value of these molecules in order to predict post-infarction HF development. In part as a secondary effect of the growing number of myocardial infarction survivor patients due to advances in drug therapy and cardiovascular interventions [1]. Recent studies have shown the implication of hyperglycaemia in the development of HF [6], establishing an independent prognostic value for glycated haemoglobin (HbA1c) predicting the risk of HF in both diabetic and non-diabetic patients [7,8]. There are no human studies demonstrating pathophysiological or prognostic implications for advanced glycation end products (AGE) in post-infarction HF
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