What question did this study set out to answer?

To investigate the correlation between serum monocyte chemoattractant protein-1 (MCP-1) levels on admission and early functional myocardial recovery in patients undergoing primary PCI for first STEMI.

May 10, 2019BMC Cardiovascular DisordersOpen Access

Significant association between admission serum monocyte chemoattractant protein-1 and early changes in myocardial function in patients with first ST-segment elevation myocardial infarction after primary percutaneous coronary intervention

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: ST-segment elevation myocardial infarction (STEMI) (n=87). Intervention: Low admission MCP-1 (<47.85 pg/ml) vs. High admission MCP-1 (≥47.85 pg/ml). Primary outcome: Absolute early change in left ventricular ejection fraction (LVEF) at 3 months (p=0.009).

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Key result

Low admission serum MCP-1 levels were significantly associated with an early improvement in left ventricular ejection fraction at 3 months post-STEMI compared to high levels (3.77% vs -0.18%, p=0.009).

Why the study?

No previous research had investigated the correlation between serum MCP-1 levels and early changes in myocardial function in patients with STEMI after primary PCI.

Does admission serum MCP-1 level correlate with early changes in myocardial function in patients with first STEMI after primary PCI?

Population

87 consecutive STEMI patients who had undergone successful primary PCI

Comparison

Low vs high admission MCP-1 subgroups divided by median value

Design

Consecutive observational cohort study

Follow-up

3 months

Authors

YZYong ZhuRēzeknes Augstskola CHChengping HuCentral South University YDYu DuShanxi Agricultural University

Discussion

Member takes

Implication

Low MCP-1 may identify favorable early LVEF recovery post-STEMI; leaves open incremental prognostic value and need for prospective validation.

Key Points

To investigate the correlation between serum monocyte chemoattractant protein-1 (MCP-1) levels on admission and early functional myocardial recovery in patients undergoing primary PCI for first STEMI.
Consecutively enrolled 87 patients with a first STEMI undergoing successful primary percutaneous coronary intervention (PCI).
Stratified patients into two cohorts according to the median admission serum MCP-1 concentration.
Assessed hs-cTnI concentrations at baseline, 24 h, and 72 h post-PCI, and evaluated early change in left ventricular ejection fraction (LVEF) defined as LVEF at 3 months minus LVEF at 2 days post-STEMI.
Absolute early change in LVEF improved significantly more in the low admission MCP-1 group compared to the high admission group (3.77% ± 6.05% vs -0.18% ± 7.69%, p = 0.009).
Patients in the low admission MCP-1 group showed a significant increase in global LVEF at 3 months compared to baseline (59.60% ± 6.51% vs 55.79% ± 7.05%, p = 0.011), an improvement absent in the high MCP-1 group.
Admission MCP-1 independently and inversely correlated with early change in LVEF on multivariable linear regression [beta = -0.089, 95% CI (-0.163 to -0.015), p = 0.020] and positively correlated with peak hs-cTnI.

Study Design

Type

Cross-Sectional (n=87)

Blinding

Single-blind

Multicenter

Yes

Structured PICO

Does admission serum MCP-1 level correlate with early changes in myocardial function in patients with first STEMI after primary PCI?

Population

87 patients aged 18 to 80 years with first ST-segment elevation myocardial infarction who underwent successful primary percutaneous coronary intervention, followed for 3 months.

Outcome

Early change in left ventricular ejection fraction (LVEF) defined as (LVEF at 3 months post-STEMI) - (LVEF at 2 days post-STEMI)surrogate

Main Result

Absolute Event Rate: 3.77% vs -0.18%

p-value: p=0.009

Lower admission serum MCP-1 levels are associated with reduced myocardial injury and early improvement in left ventricular ejection fraction in patients with first STEMI undergoing primary PCI.

Limitations

Cross-sectional design with a relatively small sample size cannot establish causality.
Strict inclusion and exclusion criteria resulted in a relatively young cohort, potentially limiting generalizability to the broader STEMI population.
LVEF was assessed via echocardiography rather than more precise modalities like cardiac magnetic resonance imaging or SPECT.
The serum receptor CCR-2, which binds solely to MCP-1, was not measured.
Cross-sectional study with a relatively small sample size that fails to elucidate the causal relationship between MCP-1 levels upon admission and I/R injury
Strict inclusion or exclusion criteria make the patients relatively young and results unsuitable for the general population
Did not apply cardiac magnetic resonance imaging or single-photon emission computed tomography imaging to assess LVEF
Serum receptor CCR-2 that binds solely to MCP-1 was not measured

Cite This Study

Zhu et al. (2019) conducted a cross-sectional in ST-segment elevation myocardial infarction (STEMI) (n=87). Low admission MCP-1 (<47.85 pg/ml) vs. High admission MCP-1 (≥47.85 pg/ml) was evaluated on Absolute early change in left ventricular ejection fraction (LVEF) at 3 months (p=0.009). Low admission serum MCP-1 levels were significantly associated with an early improvement in left ventricular ejection fraction at 3 months post-STEMI compared to high levels (3.77% vs -0.18%, p=0.009).

synapsesocial.com/papers/6a9eef99d7c8d0d81aa5355d https://doi.org/10.1186/s12872-019-1098-z

Topics

STEMI management Percutaneous coronary intervention

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Implication

Low MCP-1 may identify favorable early LVEF recovery post-STEMI; leaves open incremental prognostic value and need for prospective validation.

Significant association between admission serum monocyte chemoattractant protein-1 and early changes in myocardial function in patients with first ST-segment elevation myocardial infarction after primary percutaneous coronary intervention

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Topics

Significant association between admission serum monocyte chemoattractant protein-1 and early changes in myocardial function in patients with first ST-segment elevation myocardial infarction after primary percutaneous coronary intervention

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Topics

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