RANTES (CCL5) as a biomarker of clinical outcomes in STEMI patients

Abstract

RANTES or CCL5 is a chemokine that mediates chemotaxis and activation of T cells, monocytes, granulocytes, mast cells and dendritic cells. It is involved in the pathogenesis of several diseases including atherosclerosis but its role at the acute phase of myocardial infarction (MI) is not clear. Our objective is to determine whether the serum level of RANTES is a marker of the severity of acute MI. The study included 260 consecutive STEMI patients who underwent PCI into a prospective cohort. For determination of circulating RANTES serum level, peripheral venous blood samples were taken at 5 time points: admission, 4, 24, 48 hours and 1 month after admission (H0, H4, H24, H48, M1). RANTES serum levels were assessed using enzyme-linked immunosorbent assay (ELISA). Patients underwent cardiac magnetic resonance imaging at one month. Major adverse cardiovascular events (MACE: death, hospitalization for heart failure, MI, stroke) were prospectively recorded over the 12-month follow-up. Mean age of the study population was 59 ± 12 years and 54.6% patients exhibited anterior MI. Serum RANTES level raised from 12.6 [7.6–20.8] ng/mL at H0 to 13.9 [7.6–20.8] ng/mL at H4 and decreased gradually until 1 month at 9.3 [4.9–13.6] ng/mL (Kruskal–Wallis test, P < 0.0001). RANTES area under curve (AUC) level was not correlated with IS (r = −0.03, P = 0.70) or LVEF assessed by MRI (r = 0.02, P = 0.80). Patients with a RANTES AUC serum level below the first tertile value of the population (411.0 ng.h.mL−1) were more likely to have a MACE during the first 12 months after STEMI [hazard ratio at 2.9 (1.3–6.6), P = 0.01]. In a multivariable Cox regression analysis with a model including age, gender, troponin peak, and TIMI flow grade after PCI, RANTES AUC serum level below the first tertile remained associated with an increased risk of experiencing MACE during the 12 months of follow-up [adjusted HR = 2.6 (1.2–5.8), P = 0.02]. A low level of circulating RANTES at the acute phase of STEMI was associated with an increased risk of experiencing MACE in our population. Serum RANTES might be a valuable prognostic marker in STEMI patients.