High plasma C1M levels independently predicted 46% increased risk of all-cause mortality at 1 year after STEMI, improving the GRACE risk score prediction (HR 1.46, 95% CI 1.15-1.85, p<0.0001).
Observational (n=1,616)
Yes
Do elevated levels of collagen type I degradation biomarkers (C1M and C1SIG) predict 1-year all-cause mortality in patients with STEMI?
The collagen type I degradation biomarker C1M measured at admission is an independent predictor of 1-year all-cause mortality in patients with STEMI, adding predictive value to the GRACE risk score.
Effect estimate: HR 1.46 (95% CI 1.15-1.85) for C1M highest quartile versus lower quartiles (95% CI 1.15-1.85)
p-value: p=<0.0001
Abstract Background and aims Tissue remodelling and extracellular matrix (ECM) changes are primary consequences of ST-elevated myocardial infarction (STEMI), leading to an increased risk of developing heart failure and mortality. Collagen type I is the top constituent of the cardiac ECM and is rapidly degraded at sites of tissue injury occurring in STEMI. We aimed to investigate the prognostic potential of a novel biomarker of a collagen type I-derived signalling peptide (C1SIG) shown to be involved in left ventricular remodelling after MI and compare this against another collagen type I fragment quantified by the established C1M assay in a large STEMI cohort. Methods Plasma C1SIG and C1M were quantified using specific enzyme-linked immunosorbent assays in 1616 individuals upon admittance to hospital with STEMI. Patients were then followed up for all-cause mortality over 1 year, and survival analyses were performed. Results Short-term biomarker changes assessed in a subgroup ( n = 140) showed increased circulating C1M and C1SIG in the short period from admission with STEMI up to 12 h post-admission (both, p < 0.0001). High C1M levels, defined by the highest quartile, and high C1SIG levels, defined by the median, were associated with reduced survival probability at 1 year (both, p < 0.0001) post-admission. The association was further supported in univariate and maintained for C1M only in multivariate Cox proportional hazard regression models adjusted for multiple confounders (HR 95% CI 1.46 1.15–1.85). Added value analysis determined the additional predictive value of C1M to the clinically used GRACE risk score for cardiovascular event prediction ( p = 0.0002). Conclusion C1M and C1SIG are dynamic biomarkers of collagen type I degradation, where C1SIG is also suspected to be a collagen signal. C1M is an independent predictor of all-cause mortality within a year of a MI. Graphical Abstract
Martin et al. (Wed,) conducted a observational in Individuals admitted with verified ST-elevated myocardial infarction (STEMI) (n=1,616). Plasma biomarker measurement of collagen type I degradation peptides (C1M and novel C1SIG) vs. Lower levels of C1M and C1SIG biomarkers was evaluated on All-cause mortality within 1 year after admission with STEMI (HR 1.46 (95% CI 1.15-1.85) for C1M highest quartile versus lower quartiles, 95% CI 1.15-1.85, p=<0.0001). High plasma C1M levels independently predicted 46% increased risk of all-cause mortality at 1 year after STEMI, improving the GRACE risk score prediction (HR 1.46, 95% CI 1.15-1.85, p<0.0001).