Cargando…
Mitochondrial Biomarkers in Patients with ST-Elevation Myocardial Infarction and Their Potential Prognostic Implications: A Prospective Observational Study
Background: Mitochondrial biomarkers have been investigated in different critical settings, including ST-elevation myocardial infarction (STEMI). Whether they provide prognostic information in STEMI, complementary to troponins, has not been fully elucidated. We prospectively explored the in-hospital...
Autores principales: | , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828727/ https://www.ncbi.nlm.nih.gov/pubmed/33451159 http://dx.doi.org/10.3390/jcm10020275 |
_version_ | 1783641076399079424 |
---|---|
author | Cosentino, Nicola Campodonico, Jeness Moltrasio, Marco Lucci, Claudia Milazzo, Valentina Rubino, Mara De Metrio, Monica Marana, Ivana Grazi, Marco Bonomi, Alice Veglia, Fabrizio Lauri, Gianfranco Bartorelli, Antonio L. Marenzi, Giancarlo |
author_facet | Cosentino, Nicola Campodonico, Jeness Moltrasio, Marco Lucci, Claudia Milazzo, Valentina Rubino, Mara De Metrio, Monica Marana, Ivana Grazi, Marco Bonomi, Alice Veglia, Fabrizio Lauri, Gianfranco Bartorelli, Antonio L. Marenzi, Giancarlo |
author_sort | Cosentino, Nicola |
collection | PubMed |
description | Background: Mitochondrial biomarkers have been investigated in different critical settings, including ST-elevation myocardial infarction (STEMI). Whether they provide prognostic information in STEMI, complementary to troponins, has not been fully elucidated. We prospectively explored the in-hospital and long-term prognostic implications of cytochrome c and cell-free mitochondrial DNA (mtDNA) in STEMI patients undergoing primary percutaneous coronary intervention. Methods: We measured cytochrome c and mtDNA at admission in 466 patients. Patients were grouped according to mitochondrial biomarkers detection: group 1 (−/−; no biomarker detected; n = 28); group 2 (−/+; only one biomarker detected; n = 283); group 3 (+/+; both biomarkers detected; n = 155). A composite of in-hospital mortality, cardiogenic shock, and acute pulmonary edema was the primary endpoint. Four-year all-cause mortality was the secondary endpoint. Results: Progressively lower left ventricular ejection fractions (52 ± 8%, 49 ± 8%, 47 ± 9%; p = 0.006) and higher troponin I peaks (54 ± 44, 73 ± 66, 106 ± 81 ng/mL; p = 0.001) were found across the groups. An increase in primary (4%, 14%, 19%; p = 0.03) and secondary (10%, 15%, 23%; p = 0.02) endpoint rate was observed going from group 1 to group 3. The adjusted odds ratio increment of the primary endpoint from one group to the next was 1.65 (95% CI 1.04–2.61; p = 0.03), while the adjusted hazard ratio increment of the secondary endpoint was 1.55 (95% CI 1.12–2.52; p = 0.03). The addition of study group allocation to admission troponin I reclassified 12% and 22% of patients for the primary and secondary endpoint, respectively. Conclusions: Detection of mitochondrial biomarkers is common in STEMI and seems to be associated with in-hospital and long-term outcome independently of troponin. |
format | Online Article Text |
id | pubmed-7828727 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-78287272021-01-25 Mitochondrial Biomarkers in Patients with ST-Elevation Myocardial Infarction and Their Potential Prognostic Implications: A Prospective Observational Study Cosentino, Nicola Campodonico, Jeness Moltrasio, Marco Lucci, Claudia Milazzo, Valentina Rubino, Mara De Metrio, Monica Marana, Ivana Grazi, Marco Bonomi, Alice Veglia, Fabrizio Lauri, Gianfranco Bartorelli, Antonio L. Marenzi, Giancarlo J Clin Med Article Background: Mitochondrial biomarkers have been investigated in different critical settings, including ST-elevation myocardial infarction (STEMI). Whether they provide prognostic information in STEMI, complementary to troponins, has not been fully elucidated. We prospectively explored the in-hospital and long-term prognostic implications of cytochrome c and cell-free mitochondrial DNA (mtDNA) in STEMI patients undergoing primary percutaneous coronary intervention. Methods: We measured cytochrome c and mtDNA at admission in 466 patients. Patients were grouped according to mitochondrial biomarkers detection: group 1 (−/−; no biomarker detected; n = 28); group 2 (−/+; only one biomarker detected; n = 283); group 3 (+/+; both biomarkers detected; n = 155). A composite of in-hospital mortality, cardiogenic shock, and acute pulmonary edema was the primary endpoint. Four-year all-cause mortality was the secondary endpoint. Results: Progressively lower left ventricular ejection fractions (52 ± 8%, 49 ± 8%, 47 ± 9%; p = 0.006) and higher troponin I peaks (54 ± 44, 73 ± 66, 106 ± 81 ng/mL; p = 0.001) were found across the groups. An increase in primary (4%, 14%, 19%; p = 0.03) and secondary (10%, 15%, 23%; p = 0.02) endpoint rate was observed going from group 1 to group 3. The adjusted odds ratio increment of the primary endpoint from one group to the next was 1.65 (95% CI 1.04–2.61; p = 0.03), while the adjusted hazard ratio increment of the secondary endpoint was 1.55 (95% CI 1.12–2.52; p = 0.03). The addition of study group allocation to admission troponin I reclassified 12% and 22% of patients for the primary and secondary endpoint, respectively. Conclusions: Detection of mitochondrial biomarkers is common in STEMI and seems to be associated with in-hospital and long-term outcome independently of troponin. MDPI 2021-01-13 /pmc/articles/PMC7828727/ /pubmed/33451159 http://dx.doi.org/10.3390/jcm10020275 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Cosentino, Nicola Campodonico, Jeness Moltrasio, Marco Lucci, Claudia Milazzo, Valentina Rubino, Mara De Metrio, Monica Marana, Ivana Grazi, Marco Bonomi, Alice Veglia, Fabrizio Lauri, Gianfranco Bartorelli, Antonio L. Marenzi, Giancarlo Mitochondrial Biomarkers in Patients with ST-Elevation Myocardial Infarction and Their Potential Prognostic Implications: A Prospective Observational Study |
title | Mitochondrial Biomarkers in Patients with ST-Elevation Myocardial Infarction and Their Potential Prognostic Implications: A Prospective Observational Study |
title_full | Mitochondrial Biomarkers in Patients with ST-Elevation Myocardial Infarction and Their Potential Prognostic Implications: A Prospective Observational Study |
title_fullStr | Mitochondrial Biomarkers in Patients with ST-Elevation Myocardial Infarction and Their Potential Prognostic Implications: A Prospective Observational Study |
title_full_unstemmed | Mitochondrial Biomarkers in Patients with ST-Elevation Myocardial Infarction and Their Potential Prognostic Implications: A Prospective Observational Study |
title_short | Mitochondrial Biomarkers in Patients with ST-Elevation Myocardial Infarction and Their Potential Prognostic Implications: A Prospective Observational Study |
title_sort | mitochondrial biomarkers in patients with st-elevation myocardial infarction and their potential prognostic implications: a prospective observational study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828727/ https://www.ncbi.nlm.nih.gov/pubmed/33451159 http://dx.doi.org/10.3390/jcm10020275 |
work_keys_str_mv | AT cosentinonicola mitochondrialbiomarkersinpatientswithstelevationmyocardialinfarctionandtheirpotentialprognosticimplicationsaprospectiveobservationalstudy AT campodonicojeness mitochondrialbiomarkersinpatientswithstelevationmyocardialinfarctionandtheirpotentialprognosticimplicationsaprospectiveobservationalstudy AT moltrasiomarco mitochondrialbiomarkersinpatientswithstelevationmyocardialinfarctionandtheirpotentialprognosticimplicationsaprospectiveobservationalstudy AT lucciclaudia mitochondrialbiomarkersinpatientswithstelevationmyocardialinfarctionandtheirpotentialprognosticimplicationsaprospectiveobservationalstudy AT milazzovalentina mitochondrialbiomarkersinpatientswithstelevationmyocardialinfarctionandtheirpotentialprognosticimplicationsaprospectiveobservationalstudy AT rubinomara mitochondrialbiomarkersinpatientswithstelevationmyocardialinfarctionandtheirpotentialprognosticimplicationsaprospectiveobservationalstudy AT demetriomonica mitochondrialbiomarkersinpatientswithstelevationmyocardialinfarctionandtheirpotentialprognosticimplicationsaprospectiveobservationalstudy AT maranaivana mitochondrialbiomarkersinpatientswithstelevationmyocardialinfarctionandtheirpotentialprognosticimplicationsaprospectiveobservationalstudy AT grazimarco mitochondrialbiomarkersinpatientswithstelevationmyocardialinfarctionandtheirpotentialprognosticimplicationsaprospectiveobservationalstudy AT bonomialice mitochondrialbiomarkersinpatientswithstelevationmyocardialinfarctionandtheirpotentialprognosticimplicationsaprospectiveobservationalstudy AT vegliafabrizio mitochondrialbiomarkersinpatientswithstelevationmyocardialinfarctionandtheirpotentialprognosticimplicationsaprospectiveobservationalstudy AT laurigianfranco mitochondrialbiomarkersinpatientswithstelevationmyocardialinfarctionandtheirpotentialprognosticimplicationsaprospectiveobservationalstudy AT bartorelliantoniol mitochondrialbiomarkersinpatientswithstelevationmyocardialinfarctionandtheirpotentialprognosticimplicationsaprospectiveobservationalstudy AT marenzigiancarlo mitochondrialbiomarkersinpatientswithstelevationmyocardialinfarctionandtheirpotentialprognosticimplicationsaprospectiveobservationalstudy |