Why the study?
How do circulating levels of PTX3, CypA, and HB-EGF change after pPCI in STEMI patients, and do they differ between STEMI-CAD and MINOCA?
Observational (n=81)
How do circulating levels of PTX3, CypA, and HB-EGF change after pPCI in STEMI patients, and do they differ between STEMI-CAD and MINOCA?
Absolute Event Rate: 1.52% vs 2.17%
p-value: p=<0.001
Inflammatory biomarkers PTX3, CypA, and HB-EGF change significantly immediately after pPCI in STEMI patients, and PTX3 levels differ between STEMI-CAD and MINOCA, though diagnostic accuracy is low.
Inflammatory biomarkers – pentraxin-3 (PTX3), cyclophilin A (CypA) and heparin-binding epidermal growth factor-like growth factor (HB-EGF) were examined in patients with ST-segment elevation myocardial infarction (STEMI) undergoing revascularization with primary percutaneous coronary intervention (pPCI) and stent implanting. Investigated parameters were compared between patients with and without obstructive coronary artery disease (CAD). In addition, their changes were tested in circulation before and immediately after pPCI. The study group consisted of 81 STEMI patients. Patients were classified in the STEMI-CAD group if they had significant obstructive CAD or in MINOCA group if they had no significant stenosis. In STEMI-CAD patients inflammatory parameters were determined prior to and after pPCI intervention. Immediately after pPCI, in STEMI-CAD patients levels of PTX3 were significantly lower (1.52 vs. 2.17 μg/L, p < .001), while the levels of HB-EGF (14.61 vs. 12.03 pg/L, p < .001) and CyPA (15.95 vs. 8.62 μg/L, p < .001) were significantly higher compared to levels before pPCI. STEMI–CAD patients had lower PTX3 values 2.17 μg/L (1.55–5.10 μg/L) than MINOCA patients 5.06 μg/L (2.77–6.7 μg/L), p = .046. Diagnostic accuracy of PTX3 for discrimination MINOCA from STEMI-CAD patients was low (area under receiver operating characteristic curve = 0.770). Evaluation of PTX3 values may be helpful in the understanding of MINOCA aetiology but they couldn’t distinguish stenosis severity in STEMI patients. Inflammatory biomarkers significantly changed after pPCI but the possibility of clinical use of these biomarkers needs to be evaluated in a larger prospective study.
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Vuković-Dejanović et al. (2019) conducted an observational in ST-segment elevation myocardial infarction (STEMI) (n=81). Primary percutaneous coronary intervention (pPCI) vs. Before pPCI was evaluated on PTX3 levels (μg/L) (p=<0.001).
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