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Biomarker Concentra...
Biomarker Concentrations and Their Temporal Changes in Patients With Myocardial Infarction and Nonobstructive Compared With Obstructive Coronary Arteries : Results From the PLATO Trial
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- Hjort, Marcus, 1988- (author)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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- Eggers, Kai M., 1962- (author)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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- Ghukasyan Lakic, Tatevik (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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- Lindbäck, Johan (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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- Budaj, Andrzej (author)
- Department of Cardiology, Centre of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
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- Cornel, Jan H. (author)
- Department of Cardiology, Northwest Clinics, Alkmaar, and Radboud University Medical Center, Nijmegen, the Netherlands
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- Giannitsis, Evangelos (author)
- Department of Medicine III, University of Heidelberg, Heidelberg, Germany
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- Katus, Hugo A. (author)
- Department of Medicine III, University of Heidelberg, Heidelberg, Germany
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- Siegbahn, Agneta, 1947- (author)
- Uppsala universitet,Koagulation och inflammationsvetenskap
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- Storey, Robert F. (author)
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
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- Becker, Richard C. (author)
- Division of Cardiovascular Health and Diseases, University of Cincinnati Heart, Lung & Vascular Institute, Cincinnati, USA
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- Wallentin, Lars, 1943- (author)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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- Lindahl, Bertil, 1957- (author)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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(creator_code:org_t)
- American heart association, 2023
- 2023
- English.
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In: Journal of the American Heart Association. - : American heart association. - 2047-9980. ; 12:1
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https://doi.org/10.1...
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https://uu.diva-port... (primary) (Raw object)
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https://urn.kb.se/re...
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Abstract
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- Background: The pathobiology of myocardial infarction (MI) with nonobstructive coronary arteries (MINOCA) is often uncertain. Investigating biomarker concentrations and their changes may offer novel pathophysiological insights.Methods and Results: In this post hoc study of the PLATO (Platelet Inhibition and Patient Outcomes) trial, concentrations of hs‐cTnT (high‐sensitivity cardiac troponin T), NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide), hs‐CRP (high‐sensitivity C‐reactive protein), and GDF‐15 (growth differentiation factor 15) were measured in patients with MINOCA at baseline (n=554) and at 1‐month follow‐up (n=107). For comparisons, biomarkers were also measured in patients with MI with obstructive (stenosis ≥50%) coronary artery disease (baseline: n=11 106; follow‐up: n=2755]). Adjusted linear regression models were used to compare concentrations and their short‐ and long‐term changes. The adjusted geometric mean ratios (GMRs) in patients with MINOCA (median age, 61 years; 50.4% women) indicated lower hs‐cTnT (GMR, 0.77 [95% CI, 0.68–0.88]) but higher hs‐CRP (GMR, 1.21 [95% CI, 1.08–1.37]) and GDF‐15 concentrations (GMR, 1.06 [95% CI, 1.02–1.11]) at baseline compared with patients with MI with obstructive coronary artery disease, whereas NT‐proBNP concentrations were similar. Temporal decreases in hs‐cTnT, NT‐proBNP, and hs‐CRP concentrations until 1‐month follow‐up were more pronounced in patients with MINOCA. At follow‐up, patients with MINOCA had lower concentrations of hs‐cTnT (GMR, 0.71 [95% CI, 0.60–0.84]), NT‐proBNP (GMR, 0.45 [95% CI, 0.36–0.56]), and hs‐CRP (GMR, 0.68 [95% CI, 0.53–0.86]). One‐month GDF‐15 concentrations were similar between both groups with MI.Conclusions: Biomarker concentrations suggest greater initial inflammatory activity, similar degree of myocardial dysfunction, and less pronounced myocardial injury during the acute phase of MINOCA compared with MI with obstructive coronary artery disease but also faster myocardial recovery.CLINICAL TRAIL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00391872.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- myocardial infarction; MINOCA; biomarkers; pathophysiology
- hjärtinfarkt
- MINOCA
- biomarkörer
- patofysiologi
- Kardiologi
- Cardiology
Publication and Content Type
- ref (subject category)
- art (subject category)
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Hjort, Marcus, 1 ...
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Eggers, Kai M., ...
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Ghukasyan Lakic, ...
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Lindbäck, Johan
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Budaj, Andrzej
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Cornel, Jan H.
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Giannitsis, Evan ...
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Katus, Hugo A.
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Siegbahn, Agneta ...
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Storey, Robert F ...
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Becker, Richard ...
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Wallentin, Lars, ...
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Lindahl, Bertil, ...
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- MEDICAL AND HEALTH SCIENCES
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Uppsala University