Temporal trajectory and left ventricular ejection fraction association of eight circulating biomarkers in first acute myocardial infarction patients: a 12-month prospective cohort study.

European heart journal open Pub Date : 2024-10-15 eCollection Date: 2024-09-01 DOI:10.1093/ehjopen/oeae090
Meyer Elbaz, Marie-Hélène Grazide, Vincent Bataille, Grégoire Blanc, Anne-Valérie Cantero, Hueseyin Firat, Cécile Vindis
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Abstract

Aims: Our study aimed to explore the temporal trajectory of eight circulating biomarkers, measured serially over 12 months, in a prospective observational cohort of patients with acute myocardial infarction (AMI) and to investigate the association between these biomarkers and left ventricular ejection fraction (LVEF) during follow-up assessments.

Methods and results: We enrolled 155 patients admitted for a first AMI requiring percutaneous coronary intervention (PCI). Baseline characteristics, laboratory test results, and cardiac ultrasound examinations were collected at pre-PCI (H0), immediately post-PCI (H24), at discharge (D3), and at 6 months (M6) and 12 months (M12) post-PCI. Blood samples were analysed for established and emerging biomarkers described in left ventricular dysfunction: soluble suppression of tumorigenicity 2 (sST2), interleukin-6 (IL-6), osteopontin, angiopoietin-2, insulin-like growth factor-binding protein 2 (IGFBP-2), growth differentiation factor 15 (GDF-15), hepcidin, and galectin-3. Values at H24, D3, M6, and M12 were compared with value at H0. Three kinetic profiles were identified, with six biomarkers peaking during the acute MI phase. Crude relationships between clinical variables and the peak values (highest observed between H0 and D3) of each biomarker were studied. Peak levels of sST2, IL-6, osteopontin, and angiopoietin-2 demonstrated significant correlations with both baseline and follow-up LVEF values.

Conclusion: The assessment of the temporal trajectories of these biomarkers and their associations with LVEF suggests that sST2, IL-6, osteopontin, and angiopoietin-2 hold significant promise as companion biomarkers. These biomarkers may improve the identification of patients at risk for developing impaired LVEF following AMI, thereby enabling more targeted and effective management strategies.

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首次急性心肌梗死患者八种循环生物标志物的时间轨迹与左心室射血分数的关系:一项为期 12 个月的前瞻性队列研究。
目的:我们的研究旨在探索急性心肌梗死(AMI)患者前瞻性观察队列中 8 种循环生物标志物的时间轨迹,这些生物标志物是在 12 个月内连续测量的,并研究这些生物标志物与随访评估期间左心室射血分数(LVEF)之间的关联:我们招募了 155 名因首次发生急性心肌梗死(AMI)而需要经皮冠状动脉介入治疗(PCI)的患者。在PCI前(H0)、PCI后不久(H24)、出院时(D3)、PCI后6个月(M6)和12个月(M12)收集了基线特征、实验室检查结果和心脏超声检查。对血液样本进行了分析,以检测左心室功能障碍中已有的和新出现的生物标记物:可溶性抑制肿瘤生成素 2 (sST2)、白细胞介素-6 (IL-6)、骨生成素、血管生成素-2、胰岛素样生长因子结合蛋白 2 (IGFBP-2)、生长分化因子 15 (GDF-15)、肝磷脂酶和galectin-3。将 H24、D3、M6 和 M12 时的值与 H0 时的值进行比较。确定了三种动力学特征,其中六种生物标志物在急性心肌梗死阶段达到峰值。研究了临床变量与每种生物标志物峰值(H0 至 D3 期间观察到的最高值)之间的粗略关系。sST2、IL-6、骨生成素和血管生成素-2的峰值水平与基线和随访LVEF值均有显著相关性:结论:对这些生物标志物的时间轨迹及其与 LVEF 的关系的评估表明,sST2、IL-6、骨生成素和血管生成素-2 作为辅助生物标志物具有重要的前景。这些生物标志物可提高对急性心肌梗死后 LVEF 受损风险患者的识别能力,从而制定更有针对性和更有效的管理策略。
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