What is the clinical evidence from this study?

Study design: Cohort. Population: ST-segment elevation myocardial infarction (STEMI) (n=70). Intervention: 6-month plasma arginine concentration < 29 µM vs. 6-month plasma arginine concentration ≥ 29 µM. Primary outcome: Composite of death, recurrent myocardial infarction, or hospitalization due to heart failure decompensation (HR 2.76, 95% CI 1.01-7.57, p=0.047).

January 8, 2021Scientific ReportsOpen Access

The shifted balance of arginine metabolites in acute myocardial infarction patients and its clinical relevance

Q: What are the key findings of this study?

A 6-month plasma arginine concentration lower than 29 µM was independently associated with an increased risk of death, recurrent myocardial infarction, or heart failure hospitalization (HR 2.76).

Q: What does this research mean for the field?

A 6-month plasma arginine concentration lower than 29 µM in STEMI patients is independently associated with an increased risk of death, recurrent myocardial infarction, or heart failure hospitalization. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Six-month plasma arginine below 29 µM is linked to ~176% higher risk of major events.

HR 2.76
95% CI 1.01-7.57
P=0.047
n=70

Study Design

Type

Cohort (n=70)

Multicenter

Structured PICO

Population

70 consecutive STEMI patients who underwent primary percutaneous coronary intervention (PCI), median age 59.0, 77% male. Inclusion criteria: chest pain duration at rest no longer than 12 h with concomitant ST-segment elevation > 1 mm in 2 or more limb leads or > 2 mm in 2 precordial leads, or new left bundle branch block. Exclusion criteria: cardiogenic shock, pulmonary edema, history of MI or PCI at the same location, coronary artery bypass surgery, cancer, venous thromboembolism, renal or liver failure, and contraindications to cardiac magnetic resonance imaging.

Outcome

Composite of death, recurrent myocardial infarction, or hospitalization due to heart failure decompensation at 5-year follow-upcomposite

Main Result

Effect estimate: HR 2.76 (95% CI 1.01-7.57)

p-value: p=0.047

In STEMI patients, decreased 6-month plasma arginine concentrations (< 29 µM) are associated with worse long-term clinical outcomes, including death, recurrent MI, or heart failure hospitalization.

Limitations

Relatively small analyzed group
Arginine metabolites were not measured in acute phase following reperfusion
Non-fasting blood samples in acute phase of MI
Red blood cells were not examined
Lack of age matched control group
Homogenous study population in terms of race and ethnicity

Discussion

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Implication

Low 6-month arginine identifies higher-risk post-STEMI patients; leaves open whether supplementation improves outcomes.

Cite This Study

Mołek et al. (2021) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=70). 6-month plasma arginine concentration < 29 µM vs. 6-month plasma arginine concentration ≥ 29 µM was evaluated on Composite of death, recurrent myocardial infarction, or hospitalization due to heart failure decompensation (HR 2.76, 95% CI 1.01-7.57, p=0.047). A 6-month plasma arginine concentration lower than 29 µM was independently associated with an increased risk of death, recurrent myocardial infarction, or heart failure hospitalization (HR 2.76).

synapsesocial.com/papers/6a12d0ed06ed52b5c2c097a8 https://doi.org/10.1038/s41598-020-80230-3

Topics

STEMI management

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The shifted balance of arginine metabolites in acute myocardial infarction patients and its clinical relevance

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Topics

The shifted balance of arginine metabolites in acute myocardial infarction patients and its clinical relevance

Study Design

Structured PICO

Main Result

Limitations

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider