CCN family member 1 (CCN1) is an early marker of infarct size and left ventricular dysfunction in STEMI patients,Atherosclerosis

当前位置： X-MOL 学术 › Atherosclerosis › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

CCN family member 1 (CCN1) is an early marker of infarct size and left ventricular dysfunction in STEMI patients
Atherosclerosis ( IF 4.9 ) Pub Date : 2021-09-17 , DOI: 10.1016/j.atherosclerosis.2021.09.019
Thabo Mahendiran ₁ , Roland Klingenberg ₂ , David Nanchen ₃ , Baris Gencer ₄ , David Meier ₁ , Lorenz Räber ₅ , David Carballo ₃ , Christian M Matter ₅ , Thomas F Lüscher ₆ , François Mach ₃ , Nicolas Rodondi ₇ , Olivier Muller ₁ , Stephane Fournier ₁

Affiliation

Background and aims

CCN family member 1 (CCN1) has recently been proposed as a novel biomarker of myocardial injury, improving prediction of 30-day and one-year mortality following acute coronary syndromes. Among ST-elevation myocardial infarction (STEMI) patients, we evaluated the utility of CCN1 measured immediately before primary percutaneous coronary intervention (PPCI) as a predictor of two earlier endpoints: final myocardial infarct size and post-infarction left ventricular ejection fraction (LVEF). Furthermore, we evaluated the impact of CCN1 on the discriminatory power of the CADILLAC score.

Methods

STEMI patients were obtained from the SPUM-ACS cohort. Serum CCN1 was measured prior to PPCI. Linear regression assessed the association between CCN1, peak creatinine kinase (CK), and post-infarction LVEF. Cox models assessed an association between CCN1 and 30-day all-cause mortality.

Results

CCN1 was measured in 989 patients with a median value of 706.2 ng/l (IQR 434.3–1319.6). A significant correlation between CCN1, myocardial infarct size (peak CK) and LVEF was observed in univariate and multivariate analysis (both p < 0.001). Even among patients with normal classical cardiac biomarker levels at the time of PPCI, CCN1 correlated significantly with final infarct size. CCN1 significantly improved prediction of 30-day all-cause mortality by the CADILLAC score (C-index 0.864, likelihood-ratio chi-square test statistic 6.331, p = 0.012; IDI 0.026, p= 0.050).

Conclusions

Compared with classical cardiac biomarkers, CCN1 is potentially the earliest predictor of final myocardial infarct size and post-infarction LVEF. CCN1 improved the discriminatory capacity of the CADILLAC score suggesting a potential role in the very-early risk stratification of STEMI patients.

中文翻译：

CCN 家族成员 1 (CCN1) 是 STEMI 患者梗死面积和左心室功能障碍的早期标志物

背景和目标

CCN 家族成员 1 (CCN1) 最近被提议作为心肌损伤的新型生物标志物，可改善急性冠状动脉综合征后 30 天和一年死亡率的预测。在 ST 段抬高心肌梗死 (STEMI) 患者中，我们评估了在初次经皮冠状动脉介入治疗 (PPCI) 前立即测量的 CCN1 作为两个早期终点的预测指标的效用：最终心肌梗死面积和梗死后左心室射血分数 (LVEF) . 此外，我们评估了 CCN1 对 CADILLAC 评分区分能力的影响。

方法

STEMI 患者来自 SPUM-ACS 队列。在 PPCI 之前测量血清 CCN1。线性回归评估了 CCN1、峰值肌酐激酶 (CK) 和梗死后 LVEF 之间的关联。Cox 模型评估了 CCN1 与 30 天全因死亡率之间的关联。

结果

在 989 名患者中测量了 CCN1，中值为 706.2 ng/l (IQR 434.3–1319.6)。在单变量和多变量分析中观察到 CCN1、心肌梗死面积（峰值 CK）和 LVEF 之间存在显着相关性（均p < 0.001）。即使在 PPCI 时经典心脏生物标志物水平正常的患者中，CCN1 与最终梗死面积显着相关。CCN1 显着改善了 CADILLAC 评分对 30 天全因死亡率的预测（C 指数 0.864，似然比卡方检验统计量 6.331，p = 0.012；IDI 0.026，p = 0.050）。