Key result
High peripheral venous neuropeptide Y levels (>21.4 pg/mL) after primary PCI for STEMI were associated with increased heart failure and mortality (HR 3.49; 95% CI 1.65-7.4; P<0.001).
Why the study?
Neuropeptide Y is released during STEMI and can constrict coronary microvasculature, prompting investigation into whether easily obtained peripheral venous levels associate with microvascular obstruction, myocardial recovery, and prognosis.
Are high peripheral venous NPY levels associated with increased incidence of heart failure and mortality in patients with STEMI?
Cohort (n=163)
Are high peripheral venous NPY levels associated with increased incidence of heart failure and mortality in patients with STEMI?
Peripheral venous NPY levels measured immediately after primary PCI for STEMI correlate with microvascular function and are independently associated with long-term heart failure and mortality.
Background The sympathetic cotransmitter, neuropeptide Y (NPY), is released into the coronary sinus during ST‐segment–elevation myocardial infarction and can constrict the coronary microvasculature. We sought to establish whether peripheral venous (PV) NPY levels, which are easy to obtain and measure, are associated with microvascular obstruction, myocardial recovery, and prognosis. Methods and Results NPY levels were measured immediately after primary percutaneous coronary intervention and compared with angiographic and cardiovascular magnetic resonance indexes of microvascular function. Patients were prospectively followed up for 6.4 (interquartile range, 4.1–8.0) years. PV (n=163) and coronary sinus (n=68) NPY levels were significantly correlated ( r =0.92; P <0.001) and associated with multiple coronary and imaging parameters of microvascular function and infarct size (such as coronary flow reserve, acute myocardial edema, left ventricular ejection fraction, and late gadolinium enhancement 6 months later). We therefore assessed the prognostic value of PV NPY during follow‐up, where 34 patients (20.7%) developed heart failure or died. Kaplan‐Meier survival analysis demonstrated that high PV NPY levels (>21.4 pg/mL by binary recursive partitioning) were associated with increased incidence of heart failure and mortality (hazard ratio, 3.49 [95% CI, 1.65–7.4]; P <0.001). This relationship was maintained after adjustment for age, cardiovascular risk factors, and previous myocardial infarction. Conclusions Both PV and coronary sinus NPY levels correlate with microvascular function and infarct size after ST‐segment–elevation myocardial infarction. PV NPY levels are associated with the subsequent development of heart failure or mortality and may therefore be a useful prognostic marker. Further research is required to validate these findings.
No takes yet. Share an insight, caveat, or question.
Gibbs et al. (2022) conducted a cohort in ST-segment-elevation myocardial infarction (n=163). Peripheral venous neuropeptide Y (NPY) levels vs. Low peripheral venous NPY levels was evaluated on Heart failure and mortality (HR 3.49, 95% CI 1.65-7.4, p=<0.001). High peripheral venous neuropeptide Y levels (>21.4 pg/mL) after primary PCI for STEMI were associated with increased heart failure and mortality (HR 3.49; 95% CI 1.65-7.4; P<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: