title: The predictive value of M30 and oxidative stress for left ventricular remodeling in patients with anterior ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention.
abstract: BACKGROUND
  Left ventricular (LV) remodeling is an important pathophysiological event that develops following acute myocardial infarction and causes LV systolic dysfunction. Mechanisms such as apoptosis, necrosis, and oxidative stress play an important role in LV remodeling.
  
  
  OBJECTIVE
  This study aimed to determine the relationship between the development of LV remodeling and the apoptosis marker M30 in patients with anterior ST-segment elevation myocardial infarction (STEMI) who were treated with primary percutaneous coronary intervention (PCI).
  
  
  METHODS
  This retrospective study included 255 consecutive patients (210 men, 45 women, mean age 54.9±11.8 years) with anterior STEMI who were treated with primary PCI. Blood samples were obtained from each patient at admission and 24 h after admission for measurements of M30, M65, oxidative parameters, and biochemical parameters. Transthoracic echocardiography was performed in each patient within 24 h of infarction and 6 months after infarction. LV remodeling was defined as greater than or equal to 20% increase in end-diastolic volume 6 months after primary PCI. The patients were divided into two groups on the basis of 6 months of post-primary PCI follow-up findings: LV remodeling group and non-LV remodeling group.
  
  
  RESULTS
  In all, 60 patients received LV remodeling and 195 did not receive LV remodeling at 6 months after primary PCI. Total oxidative stress, M30 and M65 levels, and the oxidative stress index were significantly higher and the total antioxidant capacity and M65/M30 ratio were lower in the LV remodeling group (P<0.05, for all). Brain natriuretic peptide, M30, and oxidative stress index were independent predictors of LV remodeling (P<0.05 for all). Receiver operating characteristic curve analysis showed that the M30 cut-off value for predicting LV remodeling was 144.9 U/l (80% sensitivity and 77% specificity, P<0.001).
  
  
  CONCLUSIONS
  In patients with anterior STEMI treated with primary PCI, the apoptosis marker M30 might be useful for predicting LV remodeling and subsequent LV systolic dysfunction.
authors.affiliation: aDepartment of Cardiology, Yenimahalle Training and Research Hospital, Ankara bDepartment of Cardiology, Adana Numune Training and Research Hospital, Adana cDepartment of Cardiology, Osmaniye State Hospital, Osmaniye dDepartment of Clinical Biochemistry, School of Medicine, Bezmi-Alem University, İstanbul, Turkey.
authors.forename: Caner
authors.initials: C
authors.lastname: Türkoğlu
authors.forename: Mustafa
authors.initials: M
authors.lastname: Gür
authors.forename: Taner
authors.initials: T
authors.lastname: Şeker
authors.forename: Şahbettin
authors.initials: Ş
authors.lastname: Selek
authors.forename: Abdurrahim
authors.initials: A
authors.lastname: Koçyiğit
mesh_terms: D000328:Adult; D000368:Aged; D056988:Anterior Wall Myocardial Infarction / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D017209:Apoptosis; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D004452:Echocardiography; D005260:Female; D006801:Humans; D053538:Keratin-18 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D018384:Oxidative Stress; D010446:Peptide Fragments / Q000097:blood*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D000072657:ST Elevation Myocardial Infarction / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling
chemical_list: D015415:Biomarkers; D053538:Keratin-18; C561463:M30 cytokeratin-18 peptide, human; C577325:M65 antigen, human; D010446:Peptide Fragments; D020097:Natriuretic Peptide, Brain