Key result
Reduced arylesterase activity predicts ~325% greater one-year mortality risk after STEMI.
Why the study?
Reduced serum levels of paraoxonase 1 activities are associated with diseases involving increased oxidative stress such as acute coronary syndrome, but their prognostic value for one-year survival after STEMI was unclear.
Does reduced arylesterase activity of PON1 predict one-year mortality in patients with STEMI?
Cohort (n=75)
No
Does reduced arylesterase activity of PON1 predict one-year mortality in patients with STEMI?
Hazard Ratio: 4.25 (95% CI 0.94–19.18)
p-value: p=0.05
Reduced arylesterase activity of PON1 serves as an independent predictor of one-year mortality following STEMI.
May support PON1 activity in STEMI prognostication; hypothesis-generating and requires validation before clinical use.
Introduction: Reduced serum levels of paraoxonase 1 (PON1) activities are associated with diseases involving increased oxidative stress, such as acute coronary syndrome. We aimed to determine whether serum PON1 activities are a prognostic factor for one-year survival following ST-elevation myocardial infarction (STEMI). Material and methods: We prospectively followed for one-year 75 patients diagnosed and treated for STEMI. Clinical, laboratory and imagistic data were gathered after coronary angiography. PON1 activities (paraoxonase, arylesterase, and lactonase) were assayed spectophotometrically on samples of heparinized plasma taken from the patients in a timeframe of maximum 20 minutes after coronary angiography. Results: Increased mortality was linked to age (patients over 68 years), permanent atrial fibrillation or left ventricular ejection fraction (LVEF) <40% (associated with global hypokinesia, apical or septal akinesia), trivascular disease atherosclerosis, reduced PON1 activities (paraoxonase <18.4 IU/mL, arylesterase <12.6 IU/mL, lactonase <27.6 IU/mL), and glomerular filtration rate levels <54 mL/min/1.73m2. Multivariate survival analysis showed the independent prognostic role of age (HR 3.92; 95%CI 1.08-14.16; p=0.03), LVEF (HR 9.93; 95%CI 2.20-44.86; p=0.003) and arylesterase (HR 4.25; 95%CI 0.94-19.18; p=0.05) for one-year mortality. Conclusion : Reduced arylesterase activity of PON1 is an independent predictor of one-year survival after acute myocardial infarction.
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Ciumărnean et al. (2018) conducted a cohort in ST-elevation myocardial infarction (STEMI) (n=75). Reduced arylesterase activity (<12.6 IU/mL) vs. Arylesterase activity ≥12.6 IU/mL was evaluated on One-year mortality (HR 4.25, 95% CI 0.94-19.18, p=0.05). Reduced arylesterase activity (<12.6 IU/mL) was an independent predictor of one-year mortality following acute ST-elevation myocardial infarction (HR 4.25).
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