Relation of a novel fibrosis marker and post-myocardial infarction left ventricular ejection fraction in revascularized patients.

Abstract

Aim: To investigate the relationship between post-myocardial infarction (MI)left ventricular ejection fraction (LVEF) and fibrosis marker HE-4 in primarily revascularized patients with ST-segment elevation MI (STEMI). Patients & methods: In 94 consecutive STEMI patients (median age 57 [IQR: 50-69] years; 77.7% male), HE-4 values were measured at hospital admission and 4days after STEMI. Transthoracic echocardiography was performed 4days after STEMI (median 5days [interquartile range: 4-6]). Results: HE-4 levels 4days after STEMI were significantly higher in the low ejection fraction group (30.1 [26.0-46.5] pmol/l vs 48.5 [32.5-85.9] pmol/l, p=0.004). In the multivariable analysis, HE-4 values (odds ratio: 1.029, 95% CI: 1.012-1.046, p=0.001), troponin I levels, anterior MIand diabetes mellitus were independent predictors of low LVEF after STEMI. A negative correlation existed between ΔHE-4 levels and LVEF (r: -0.337, p=0.001). Receiver operating characteristic analysis indicated 34.01pmol/l HE-4 at4days after STEMI identified patients with low LVEF (AUC=0.707; 95% CI: 0.601-0.813; p=0.001). Conclusion: In revascularized STEMI patients, high HE-4 levels are associated with decreased LVEF. HE-4 may represent a diagnostic marker and treatment target for patients with heart failure or left ventricular systolic dysfunction after STEMI.