Potential prognostic significance of decreased serum levels of TRAIL after acute myocardial infarction.
BACKGROUND
Since soluble TRAIL exhibits anti-inflammatory and anti-atherosclerotic activities both in vitro and in animal models, this study was designed to assess the relationship between the serum levels of TRAIL and clinical outcomes in patients with acute myocardial infarction (AMI).


RESULTS
Levels of TRAIL were measured by ELISA in serial serum samples obtained from 60 patients admitted for AMI, both during hospitalization and in a follow-up of 12 months, as well as in 60 healthy control subjects. Serum levels of TRAIL were significantly decreased in patients with AMI at baseline (within 24 hours from admission), compared with healthy controls, and showed a significant inverse correlation with a series of negative prognostic markers, such as CK, CK-MB and BNP. TRAIL serum levels progressively increased at discharge, but normalized only at 6-12 months after AMI. Of note, low TRAIL levels at the patient discharge were associated with increased incidence of cardiac death and heart failure in the 12-month follow-up, even after adjustment for demographic and clinical risk parameters (hazard ratio [HR] of 0.93 [95% CI, 0.89 to 0.97]; p = 0.001).


CONCLUSIONS
Although the number of patients studied was limited, our findings indicate for the first time that circulating TRAIL might represent an important predictor of cardiovascular events, independent of conventional risk markers.
Secchiero
Paola
P
Department of Morphology and Embryology, University of Ferrara, Ferrara, Italy. paola.secchiero@unife.it
Corallini
Federica
F
Ceconi
Claudio
C
Parrinello
Giovanni
G
Volpato
Stefano
S
Ferrari
Roberto
R
Zauli
Giorgio
G
D000368:Aged; D000818:Animals; D015415:Biomarkers / Q000097:blood; D052279:Creatine Kinase, MB Form / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis; D010865:Pilot Projects; D011379:Prognosis; D012307:Risk Factors; D053221:TNF-Related Apoptosis-Inducing Ligand / Q000097:blood*
D015415:Biomarkers; D053221:TNF-Related Apoptosis-Inducing Ligand; D052279:Creatine Kinase, MB Form