title: Relationship of plasma neuropeptide Y with angiographic, electrocardiographic and coronary physiology indices of reperfusion during ST elevation myocardial infarction.
abstract: OBJECTIVE
  The co-transmitter neuropeptide Y (NPY) is released during high levels of sympathetic stimulation and is a potent vasoconstrictor. We defined the release profile of plasma NPY during acute ST elevation myocardial infarction, and tested the hypothesis that levels correlate with reperfusion measures after treatment with primary percutaneous coronary intervention (PPCI).
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  University hospital heart centre.
  
  
  METHODS
  64 patients (62.6±11.7 years-old, 73% male) presenting throughout the 24-h cycle of clinical activity with ST elevation myocardial infarction.
  
  
  METHODS
  PPCI.
  
  
  METHODS
  NPY was measured (ELISA) in peripheral blood taken before and immediately after PPCI and at 6, 24 and 48 h post-PPCI. Reperfusion was assessed by angiographic criteria, ST segment resolution, invasive measurement of coronary flow reserve and the index of microcirculatory resistance.
  
  
  RESULTS
  Plasma NPY levels were highest before PPCI (17.4 (8.8-42.2) pg/ml, median (IQR)) and dropped significantly post-PPCI (12.4 (6.5-26.7) pg/ml, p<0.0001) and after 6 h (9.0 (2.6-21.5) pg/ml, p=0.008). Patients with admission NPY levels above the median were significantly more hypertensive and tachycardic and were more likely to have diabetes mellitus. Patients with angiographic no-reflow (less than thrombolysis in myocardial infarction 3 flow and myocardial blush grade >2, n=16) or no electrocardiographic ST resolution (<70%, n=30) following PPCI had significantly higher plasma NPY levels. Patients with a coronary flow reserve <1.5 or index of microcirculatory resistance >33 also had significantly higher plasma NPY levels pre-PPCI and post-PPCI.
  
  
  CONCLUSIONS
  Plasma NPY levels correlate with indices of reperfusion and coronary microvascular resistance.
authors: Department of Cardiovascular Medicine, University of Oxford, The John Radcliffe Hospital, Oxford OX39DU, UK.
authors: Florim
authors: F
authors: Cuculi
authors: Neil
authors: N
authors: Herring
authors: Alberto R
authors: AR
authors: De Caterina
authors: Adrian P
authors: AP
authors: Banning
authors: Bernard D
authors: BD
authors: Prendergast
authors: John C
authors: JC
authors: Forfar
authors: Robin P
authors: RP
authors: Choudhury
authors: Keith M
authors: KM
authors: Channon
authors: Rajesh K
authors: RK
authors: Kharbanda
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003326:Coronary Circulation; D004562:Electrocardiography; D004739:England; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D009478:Neuropeptide Y / Q000097:blood*; D054318:No-Reflow Phenomenon / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014655:Vascular Resistance
chemical_list: D015415:Biomarkers; D009478:Neuropeptide Y
references: Blood Press. 1995 May;4(3):143-7
references: 7670647
references: Circulation. 1996 Mar 1;93(5):879-88
references: 8598078
references: J Clin Endocrinol Metab. 1989 Apr;68(4):808-13
references: 2466046
references: Eur Heart J. 2008 Aug;29(15):1843-50
references: 18617477
references: PLoS Genet. 2009 Jan;5(1):e1000318
references: 19119412
references: Am Heart J. 1994 Apr;127(4 Pt 1):774-9
references: 8154414
references: Diabet Med. 2002 May;19(5):359-65
references: 12027922
references: Neuropeptides. 2010 Dec;44(6):485-9
references: 20832114
references: Lancet. 1987 May 9;1(8541):1057-9
references: 2883396
references: J Am Coll Cardiol. 2010 Apr 20;55(16):1649-60
references: 20394867
references: J Cardiovasc Pharmacol. 1986 Nov-Dec;8(6):1113-21
references: 2434735
references: Swiss Med Wkly. 2011 Dec 09;141:w13313
references: 22161870
references: Neurosci Lett. 1989 Sep 25;104(1-2):141-6
references: 2812527
references: J Mol Cell Cardiol. 2008 Mar;44(3):477-85
references: 17996892
references: Circulation. 1998 Jun 16;97(23):2302-6
references: 9639373
references: J Am Coll Cardiol. 2009 Jul 21;54(4):281-92
references: 19608025
references: Eur Heart J. 2003 Jun;24(12):1120-7
references: 12804926
references: Eur Heart J. 2006 Aug;27(15):1793-8
references: 16829540
references: J Mol Cell Cardiol. 2012 Mar;52(3):667-76
references: 22172449
references: Peptides. 2004 Apr;25(4):533-42
references: 15165707
references: Circulation. 2000 Jan 18;101(2):125-30
references: 10637197
references: Cardiovasc Res. 1990 Feb;24(2):102-8
references: 2328516
references: Curr Top Med Chem. 2007;7(17):1692-703
references: 17979778
references: Int J Cardiol. 2010 May 28;141(2):175-81
references: 19144424
references: J Am Heart Assoc. 2012 Aug;1(4):e002246
references: 23130166
references: Circulation. 1998 Mar 3;97(8):765-72
references: 9498540
references: Eur Heart J. 1994 Apr;15(4):454-61
references: 8070470
references: Circulation. 2000 Aug 29;102(9):987-93
references: 10961962
references: Circulation. 2006 May 2;113(17):2054-61
references: 16636168