Neprilysin levels at the acute phase of ST‐elevation myocardial infarction

Background Several preliminary analyses suggested an association between neprilysin (NEP) levels and myocardial infarction. Hypothesis The objective was to assess whether NEP plasma levels following reperfusion might be a surrogate for infarct size (IS) or predict adverse outcomes in acute ST‐segmen...

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Published in:Clinical cardiology (Mahwah, N.J.) N.J.), 2019-01, Vol.42 (1), p.32-38
Main Authors: Bernelin, Hugo, Mewton, Nathan, Si‐Mohamed, Salim, Croisille, Pierre, Rioufol, Gilles, Bonnefoy‐Cudraz, Eric, Douek, Philippe, Dufay, Nathalie, Amaz, Camille, Jossan, Claire, Ovize, Michel, Bochaton, Thomas
Format: Article
Language:English
Subjects:
Bioengineering
Biomarkers - blood
Clinical Investigations
CMR
Ejection fraction
Electrocardiography
Enzyme-Linked Immunosorbent Assay
Female
Follow-Up Studies
Health risk assessment
Heart attacks
Humans
Imaging
interleukine‐6
Life Sciences
Magnetic Resonance Imaging, Cine - methods
Male
Membrane Proteins - blood
Middle Aged
Myocardium - pathology
neprilysin
Percutaneous Coronary Intervention
Prognosis
Prospective Studies
ST Elevation Myocardial Infarction - blood
ST Elevation Myocardial Infarction - diagnosis
ST Elevation Myocardial Infarction - surgery
STEMI
Time Factors
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Summary:Background Several preliminary analyses suggested an association between neprilysin (NEP) levels and myocardial infarction. Hypothesis The objective was to assess whether NEP plasma levels following reperfusion might be a surrogate for infarct size (IS) or predict adverse outcomes in acute ST‐segment elevation myocardial infarction (STEMI) patients. Methods We measured NEP levels in a prospective cohort of 203 patients with STEMI referred for primary percutaneous coronary intervention. Circulating soluble NEP was measured by enzyme‐linked immunosorbent assay at admission (t0) and 4 hours later (t4) following reperfusion and on 7 times points (t0, t4, t12, t24, t48, day 7 and day 30) in a subset of 21 patients. IS and left ventricular ejection fraction (LVEF) were measured at 1 month by cardiac magnetic resonance. Adverse cardiovascular outcomes were collected at 12‐month follow‐up. Results Median t0 and t4 NEP levels in 203 patients were respectively 88.3 pg/mL (interquartile range [IQR] [14; 375.4]) and 101.5 pg/mL (IQR [18.5; 423.8]). These levels remained unchanged over 1 month (P = 0.70). NEP levels did not correlate significantly with IS (P = 0.51) or LVEF (P = 0.34). There was no correlation between NEP and troponin, creatine kinase and interleukin‐6 levels at h0 and h4. NEP levels above the median were not associated with adverse outcomes at follow‐up (hazard ratio = 1.28, 95% confidence interval [0.69; 2.37]; P = 0.42). Conclusions NEP serum levels were widely distributed and did not change significantly in the first hours and 1‐month period following reperfusion in STEMI patients. There was no significant relationship with markers of infarct size and inflammation, and 1‐year adverse outcomes.
ISSN:0160-9289
1932-8737
1932-8737
DOI:10.1002/clc.23090