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Clinical significance and dynamics of biomarkers of myocardial remodeling in patients with ST segment elevation myocardial infarction and preserved left ventricular function
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1Research Institute for Complex Issues of Cardiovascular Diseases - Kemerovo - Russian Federation
Objective: to determine the clinical significance of markers of myocardial remodeling (NT-proBNP, galectin-3, sST2, MMP-1, 2, 3 and TIMP-1) in patients with ST-segment elevation myocardial infarction and preserved left ventricular function.
Materials and methods: 100 consecutive patients diagnosed with ST segment elevation myocardial infarction and LV ejection fraction =40% were included. Echocardiography was performed for all patients on the first day, 10th-12th day of hospitalization and one year later. In all patients on admission to the hospital, on the 10th-12th day and a year later, MI was used to determine serum concentrations of markers: MMP-1, 2 and 3, TIMP-1 , galectin-3; NT-proBNP; soluble protein of the IL-1 receptor family (sST2).
Results: The concentration of MMP-3, determined on the 10th -12th day of the MI, was 1.62 times higher than the values measured on the first day. While the concentration of soluble ST2 receptor, on the contrary, is almost twice as low on the 10th-12th day as measured on the 1st day. Also statistically significant dynamics in the period of hospitalization was determined for galectin-3 (p = 0.0001), MMP-2 (p = 0.0003), NT-proBNP (p = 0.0361). A year later, from the index MI, the value of markers decreased: NT-proBNP - 9.9 times compared with the values of 1-day MI and 2.54 times compared with 12 days from MI; sST2 - 1,9 times in comparison with the values of 1-day MI; galectin-3 - 1,76 times compared with the values of 1-day MI and 1.4 times compared with 12 days from MI; MMP-2 - in 1,3 times in comparison with the values of 1 day of MI and in 1,5 times in comparison with 12th days from MI. The values of MMP-3 and TIMP-1 a year later from the index event increased on the contrary: MPP-3 - 1.7 times compared with the values of 1-day MI; TIMP-1 - in 1,94 times compared with the values of 1-day MI and 2.04 times compared with 12 days from MI. Analyzing the differences in the concentrations of the markers under study, taking into account the presence / absence of signs of DD, draws attention to the fact of large median values in the group of patients with DD (n = 38): galectin-3 at each of the observation points, NT-proBNP by 10-12- day and in a year, MMP-1 - on the 1st and 10-12th day of observation, MMP-2 - at the annual observation stage, MMP-3 - on the 1st and 10-12th days from the MI, TIMP-1 - on the contrary, in the group of patients with DD the concentrations were lower in comparison with patients without DD (n = 62) both on the 1st day and a year later. Conclusions: It was determined that in the group of patients with ST segment elevation myocardial infarction and preserved LV function in the hospital period and a year later, a statistically significant dynamics of the majority of studied markers: galectin-3, MMP-2, MMP-3, sST2, Nt-proBNP, TIMP-1 , which testify about regular processes of structural and functional remodeling of myocardium of the LV at different stages of observation.
ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.
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