Abstract
This study was designed to investigate the predictive value of serum collagen biomarkers on the outcomes of acute ST-elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI). Two hundred and ten patients with STEMI were successfully treated with PCI within 6 hrs ofthe onset of chest pain. The levels of serum procollagen type I carboxyterminal peptide (PICP) and procollagen type III peptide (PIIINP) were measured by enzymelinked immunosorbent assay (ELISA) before, 3 and 6 months after PCI. Left ventricular ejection fraction was assessed by echocardiography at 3 and 6 months after PCI. The composite endpoints were death by any cause, recurrent myocardial infarction, heart failure or stroke. At the end of the 12-month follow up, 29 patients (13.8%) experienced an end point. The level of serum PICP in patients with an end point was higher than in patients without an end point 7 days (19.45 ± 2.17 vs 14.95 ± 3.07 ng/mL, P<0.05) or 3 month after the PCI (29.87 ± 3.02 vs 22.14 ± 3.33 ng/mL, P<0.05). The serum PIIINP level in patients with an end point was also higher than those without 7 days after PCI (59.34 ± 4.23 vs 48.78 ± 4.23 ng/mL, P<0.05). Multivariate logistic regression analysis showed day 7 (OR=2.170, 95% CI 1.583-4.345, P=0.01) and 3-month serum PICP (OR=2.340, 95% CI 1.431-4.650, P=0.01) were independent predictors of composite end points. Persistent elevation of serum collagen marker PICP three months after PCI predicts an adverse outcome for patients with acute ST-elevation myocardial infarction.
Highlights
Acute ST-segment elevation myocardial infarction (STEMI) is a leading cause of morbidity and mortality
The main findings of this study are: a) There was an elevation in the serum procollagen type I carboxyterminal peptide (PICP) and PIIINP within the first three months of percutaneous coronary intervention (PCI) in patients with STEMI; b) The day 7 and 3-month levels of PICP and PIIINP in patients who suffered from a major adverse cardiovascular event were higher than in patients without a major cardiovascular event 12 months after the PCI; c) Together with age and post-PCI left ventricular ejection fraction, the serum levels of PICP 7 days and 3 months after the PCI are an independent predictor of adverse cardiovascular events
These results suggest that post-PCI levels of PICP may be used to assess patient’s risk and to facilitate post-procedural monitoring and management
Summary
Acute ST-segment elevation myocardial infarction (STEMI) is a leading cause of morbidity and mortality. We investigated the relations between post-PCI levels of serum PICP and PIIINP and the clinical outcome in patients with STEMI. Pearson correlation analysis was performed to assess the relations between the serum levels of PICP and PIIINP and the left ventricular ejection fraction.
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