title: Soluble TNF-related apoptosis induced ligand (sTRAIL) is augmented by Post-Conditioning and correlates to infarct size and left ventricle dysfunction in STEMI patients: a substudy from a randomized clinical trial.
abstract: Low levels of Soluble TNF-related apoptosis induced ligand (sTRAIL) seem to be related to worse prognosis after an acute coronary syndrome. PostConditioning (PostCond) may protect the heart from reperfusion injury. We sought to evaluate the impact of PostCond on sTRAIL in relationship to infarct size (area under the curve of Troponin T, AUCTnT) and left ventricle ejection fraction (LVEF) in a series of patients undergoing primary coronary intervention for ST-segment elevation myocardial infarction (STEMI). In a substudy of a randomized trial that tested the effects of PostCond in STEMI-patients, sTRAIL was measured 24 h after reperfusion (PostCond n = 39, Control n = 39). Correlations between sTRAIL and both AUCTnT and LVEF were studied for each study arm. At 24 h, sTRAIL was higher for PostCond vs Controls (46.4 ± 30.6 vs 32.9 ± 23.4, p = 0.031), was negatively related to AUCTnT [B = -0.09, 95 % CI (-0.15 to -0.30), p = 0.005] and was positively related to both in-hospital [B = 0.10, 95 % CI (0.02-0.17), p = 0.018], and follow-up LVEF [B = 0.21, 95 % (0.10-0.32), p = 0.001]. No significant relationship was found for Controls. On multivariate analysis, PostCond was an independent predictor for sTRAIL [B = 12.13 95 % CI (0.40-23.87), p = 0.043]. In conclusion, PostCond positively influenced sTRAIL, which was related to reduced infarct size and better LVEF. Further studies are needed to understand potential mechanisms elicited by PostCond in infarct size reduction.
authors.affiliation: Cardiology Department, Centro Hospitalar do Porto, Largo Prof. Abel Salazar 4099-001, Porto, Portugal. andrecoimbraluz@hotmail.com.
authors.forename: André
authors.initials: A
authors.lastname: Luz
authors.affiliation: Cardiology Department, Centro Hospitalar do Porto, Largo Prof. Abel Salazar 4099-001, Porto, Portugal.|Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine (FMUP), University of Porto, Porto, Portugal.
authors.forename: Mário
authors.initials: M
authors.lastname: Santos
authors.affiliation: Institute of Biomedical Sciences of "Abel Salazar" (ICBAS), University of Porto, Porto, Portugal.
authors.forename: Rui
authors.initials: R
authors.lastname: Magalhães
authors.affiliation: Clinical Chemistry Department, Centro Hospitalar do Porto, Porto, Portugal.|Institute of Biomedical Sciences of "Abel Salazar" (ICBAS), University of Porto, Porto, Portugal.
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Oliveira
authors.affiliation: Clinical Chemistry Department, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Pacheco
authors.affiliation: Cardiology Department, Centro Hospitalar do Porto, Largo Prof. Abel Salazar 4099-001, Porto, Portugal.|Institute of Biomedical Sciences of "Abel Salazar" (ICBAS), University of Porto, Porto, Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Silveira
authors.affiliation: Cardiology Department, Centro Hospitalar do Porto, Largo Prof. Abel Salazar 4099-001, Porto, Portugal.
authors.forename: Sofia
authors.initials: S
authors.lastname: Cabral
authors.affiliation: Cardiology Department, Centro Hospitalar do Porto, Largo Prof. Abel Salazar 4099-001, Porto, Portugal.|Institute of Biomedical Sciences of "Abel Salazar" (ICBAS), University of Porto, Porto, Portugal.
authors.forename: Severo
authors.initials: S
authors.lastname: Torres
authors.affiliation: Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine (FMUP), University of Porto, Porto, Portugal.
authors.forename: Adelino F
authors.initials: AF
authors.lastname: Leite-Moreira
authors.affiliation: Cardiology Department, Centro Hospitalar do Porto, Largo Prof. Abel Salazar 4099-001, Porto, Portugal.|Institute of Biomedical Sciences of "Abel Salazar" (ICBAS), University of Porto, Porto, Portugal.
authors.forename: Henrique
authors.initials: H
authors.lastname: Carvalho
mesh_terms: D000328:Adult; D000368:Aged; D017209:Apoptosis; D019540:Area Under Curve; D004452:Echocardiography; D005260:Female; D006801:Humans; D057775:Ischemic Postconditioning; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015428:Myocardial Reperfusion Injury / Q000000981:diagnostic imaging*; D062645:Percutaneous Coronary Intervention; D011174:Portugal; D000072657:ST Elevation Myocardial Infarction / Q000503:physiopathology* / Q000601:surgery; D013318:Stroke Volume; D053221:TNF-Related Apoptosis-Inducing Ligand / Q000097:blood*; D016277:Ventricular Function, Left
chemical_list: D053221:TNF-Related Apoptosis-Inducing Ligand; C505653:TNFSF10 protein, human
keywords: Apoptosis; Post-conditioning; ST-elevation myocardial infarction; sTRAIL