EpCAM and microvascular obstruction in patients with STEMI: a cardiac magnetic resonance study

Microvascular obstruction (MVO) is negatively associated with cardiac structure and worse prognosis after ST-segment elevation myocardial infarction (STEMI). Epithelial cell adhesion molecule (EpCAM), involved in epithelium adhesion, is an understudied area in the MVO setting. We aimed to determine...

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Published in:Revista española de cardiología (English ed.) 2022-05, Vol.75 (5), p.384-391
Main Authors: Ríos-Navarro, César, Gavara, José, Núñez, Julio, Revuelta-López, Elena, Monmeneu, José V., López-Lereu, María P., de Dios, Elena, Pérez-Solé, Nerea, Vila, José M., Oltra, Ricardo, Chorro, Francisco J., Bayés-Genís, Antoni, Bodi, Vicente
Format: Article
Language:eng ; spa
Subjects:
Aged
Cardiac magnetic resonance
Epithelial cell adhesion molecule
Epithelial Cell Adhesion Molecule - metabolism
Female
Humans
Infarto agudo de miocardio con elevación del segmento ST
Magnetic Resonance Imaging
Magnetic Resonance Imaging, Cine
Magnetic Resonance Spectroscopy
Male
Microcirculation
Microvascular obstruction
Middle Aged
Obstrucción microvascular
Percutaneous Coronary Intervention
Resonancia magnética cardiaca
ST Elevation Myocardial Infarction - metabolism
ST Elevation Myocardial Infarction - pathology
ST Elevation Myocardial Infarction - surgery
ST-segment elevation myocardial infarction
Stroke Volume
Ventricular Function, Left
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Summary:Microvascular obstruction (MVO) is negatively associated with cardiac structure and worse prognosis after ST-segment elevation myocardial infarction (STEMI). Epithelial cell adhesion molecule (EpCAM), involved in epithelium adhesion, is an understudied area in the MVO setting. We aimed to determine whether EpCAM is associated with the appearance of cardiac magnetic resonance (CMR)-derived MVO and long-term systolic function in reperfused STEMI. We prospectively included 106 patients with a first STEMI treated with percutaneous coronary intervention, quantifying serum levels of EpCAM 24hours postreperfusion. All patients underwent CMR imaging 1 week and 6 months post-STEMI. The independent correlation of EpCAM with MVO, systolic volume indices, and left ventricular ejection fraction was evaluated. The mean age of the sample was 59±13 years and 76% were male. Patients were dichotomized according to median EpCAM (4.48 pg/mL). At 1-week CMR, lower EpCAM was related to extensive MVO (P=.021) and larger infarct size (P=.019). At presentation, EpCAM values were significantly associated with the presence of MVO in univariate (OR, 0.58; 95%CI, 0.38-0.88; P=.011) and multivariate logistic regression models (OR, 0.55; 95%CI, 0.35-0.87; P=.010). Although MVO tends to resolve at chronic phases, decreased EpCAM was associated with worse systolic function: reduced left ventricular ejection fraction (P=.009) and higher left ventricular end-systolic volume (P=.043). EpCAM is associated with the occurrence of CMR-derived MVO at acute phases and long-term adverse ventricular remodeling post-STEMI. La obstrucción microvascular (OMV) se asocia negativamente con la estructura cardiaca y el pronóstico de los pacientes tras un infarto agudo de miocardio con elevación del segmento ST (IAMCEST). El factor epithelial cell adhesion molecule (EpCAM), implicado en la cohesión de las células epiteliales, está poco estudiado en el contexto de la OMV. Por ello, el objetivo de este estudio es evaluar en una cohorte de pacientes con IAMCEST la asociación entre la concentración de EpCAM circulante con la extensión de la OMV, determinada por resonancia magnética cardiaca (RMC), y la función sistólica en fases crónicas. Se incluyó prospectivamente a 106 pacientes con un primer IAMCEST tratados con angioplastia primaria percutánea. La concentración sérica de EpCAM se determinó 24 h tras la reperfusión coronaria. Se estudió a todos los pacientes mediante RMC a la semana y a los 6 meses del IAMCE
ISSN:1885-5857
1885-5857
DOI:10.1016/j.rec.2021.04.006