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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...

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Autores principales: 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
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
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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.
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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
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