title: Prognostic value of different serum biomarkers for left ventricular remodelling after ST-elevation myocardial infarction treated with primary percutaneous coronary intervention.
abstract: BACKGROUND
  Mortality derived from ST-elevation myocardial infarction (STEMI) has decreased due to primary percutaneous coronary intervention (PCI). Paradoxically, the incidence of heart failure secondary to left ventricular remodelling (LVR) is on the rise due to the survival derived from reperfusion strategies. The aim of this study was to assess the prognostic value for LVR of biomarkers involved in several pathophysiological mechanisms activated during STEMI treated with primary PCI.
  
  
  METHODS
  112 patients with STEMI undergoing primary PCI were evaluated. LVR was defined as a ≥20% increase in the left ventricular end-diastolic volume at 6-month follow-up assessed using echocardiogram as compared with that at discharge. Blood samples were obtained for glucose, N-terminal pro-brain natriuretic peptide, troponin T (TnT), matrix metalloproteinase 9, procollagen type-I N-terminal propeptide and high-sensitivity C reactive protein (hs-CRP).
  
  
  RESULTS
  24 patients (21%) developed LVR. Higher levels of maximum TnT, and matrix metalloproteinase 9 and hs-CRP at discharge, were detected as independent risk factors for LVR (OR 1.310, p=0.03; OR 1001, p=0.04; OR 1.040, p=0.04, respectively). Both TnT and hs-CRP showed significant ability to distinguish patients who developed LVR from those who did not, being the values that yielded the greatest sensitivity and specificity as follows: TnT 7.0 μg/l (73%, 84%), hs-CRP 30 mg/l (59%, 85%).
  
  
  CONCLUSIONS
  Myocardial necrosis, as measured by released TnT, and inflammation state evident due to circulating levels of CRP are factors that may play a major role in the development of LVR following STEMI treated with primary PCI.
authors.affiliation: Echocardiography Laboratory, Cardiology Division, Virgen del Rocio University Hospital, Manuel Siurot Avenue, Seville, Spain. jaurbanomoral@gmail.com
authors.forename: Jose Angel
authors.initials: JA
authors.lastname: Urbano-Moral
authors.forename: Jose Eduardo
authors.initials: JE
authors.lastname: Lopez-Haldon
authors.forename: Monica
authors.initials: M
authors.lastname: Fernandez
authors.forename: Fernando
authors.initials: F
authors.lastname: Mancha
authors.forename: Angel
authors.initials: A
authors.lastname: Sanchez
authors.forename: Maria Jose
authors.initials: MJ
authors.lastname: Rodriguez-Puras
authors.forename: Manuel
authors.initials: M
authors.lastname: Villa
authors.forename: Francisco
authors.initials: F
authors.lastname: Lopez-Pardo
authors.forename: Luis
authors.initials: L
authors.lastname: Diaz de la Llera
authors.forename: Juan Ignacio
authors.initials: JI
authors.lastname: Valle
authors.forename: Angel
authors.initials: A
authors.lastname: Martinez
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000503:physiopathology / Q000628:therapy; D012372:ROC Curve; D012720:Severity of Illness Index; D013997:Time Factors; D016277:Ventricular Function, Left / Q000502:physiology*; D020257:Ventricular Remodeling / Q000502:physiology*
chemical_list: D015415:Biomarkers