Relation of plasma neuropeptide-Y with myocardial function and infarct severity in acute ST-elevation myocardial infarction.
Eur J Intern Med
; 126: 63-68, 2024 Aug.
Article
de En
| MEDLINE
| ID: mdl-38555253
ABSTRACT
BACKGROUND:
Acute myocardial infarction is associated with the release of the co-transmitter neuropeptide-Y (NPY). NPY acts as a potent vasoconstrictor and is associated with microvascular dysfunction after ST-elevation myocardial infarction (STEMI). This study comprehensively evaluated the association of plasma NPY with myocardial function and infarct severity, visualized by cardiac magnetic resonance (CMR) imaging, in STEMI patients revascularized by primary percutaneous coronary intervention (PCI).METHODS:
In this observational study, we included 260 STEMI patients enrolled in the prospective MARINA-STEMI (NCT04113356) study. Plasma NPY concentrations were measured by an immunoassay 24h after PCI from peripheral venous blood samples. Left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), infarct size (IS) and microvascular obstruction (MVO) were determined using CMR imaging.RESULTS:
Median plasma concentrations of NPY were 70 [interquartile range (IQR)35-115] pg/ml. NPY levels above median were significantly associated with lower LVEF (48%vs.52%, p=0.004), decreased GLS (-8.8%vs.-12.6%, p<0.001) and larger IS (17%vs.13%, p=0.041) in the acute phase after infarction as well as after 4 months (LVEF50%vs.52%, p=0.030, GLS-10.5vs.-12.9,p<0.001,IS13%vs.10%,p=0.011). In addition, NPY levels were significantly related to presence of MVO (58%vs.52%, p=0.041). Moreover, in multivariable linear regression analysis, NPY remained significantly associated with all investigated CMR parameters (LVEFp<0.001,GLSp<0.001,ISp=0.003,MVOp=0.042) independent of other established clinical variables including high-sensitivity cardiac troponin T, pre-interventional TIMI flow 0 and left anterior descending artery as culprit lesion location.CONCLUSION:
High plasma levels of NPY, measured 24h after STEMI, were independently associated with lower LVEF, decreased GLS, larger IS as well as presence of MVO, indicating plasma NPY as a novel clinical risk marker post STEMI.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Neuropeptide Y
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Intervention coronarienne percutanée
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Infarctus du myocarde avec sus-décalage du segment ST
Limites:
Aged
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Female
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Humans
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Male
/
Middle aged
Langue:
En
Journal:
Eur J Intern Med
Sujet du journal:
MEDICINA INTERNA
Année:
2024
Type de document:
Article
Pays d'affiliation:
Autriche
Pays de publication:
Pays-Bas