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Extracellular Matrix Turnover Biomarkers Predict Long-term Left Ventricular Remodeling After Myocardial Infarction: Insights from the REVE-2 Study.
MedLine Citation:
PMID:  23983248     Owner:  NLM     Status:  Publisher    
BACKGROUND: -Extracellular matrix turnover plays a key role in wound repair post-myocardial infarction (MI). The aim of the study was to evaluate whether biomarkers of myocardial fibrosis measurements one month after MI may predict left ventricular (LV) remodeling.
METHODS AND RESULTS: -This prospective multicenter study included 246 patients with a first anterior Q-wave MI. Echocardiographic studies were performed at hospital discharge and 12 months after MI. Brain natriuretic peptide (BNP) as well as biomarkers of myocardial fibrosis (ICTP: type 1 collagen telopeptide; PINP: aminoterminal propeptide of type I procollagen; PIIINP: aminoterminal propeptide of type III procollagen) were measured one month after MI in 218 patients. In multivariate analysis, PIIINP/ICTP ratio ≤1 [OR (95%CI): 1.86(1.02-3.39), p=0.043] one month after MI, and BNP >100pg/ml [OR: 2.35(1.28-4.31, p=0.006] were associated with a pejorative LV remodeling whereas LV ejection fraction at discharge [per 5% increment: OR: 0.78(0.65-0.94), p=0.01] was independently associated with lower rates of detrimental LV remodeling at 12 months. Patients with high BNP and PIIINP/ICTP ratio ≤1, measured one month after MI, had the highest risk of developing a primary composite event (cardiovascular death or hospitalization for worsening heart failure: 14 events/216 patients, p=0.0001) during a 3-year follow-up.
CONCLUSIONS: -Myocardial fibrosis turnover after MI is associated with LV remodeling. Low PIIINP/ICTP ratio (≤1) at one month is predictive, in addition to BNP and LV ejection fraction, of detrimental LV remodeling as well as cardiovascular deaths and hospitalizations for heart failure.
Romain Eschalier; Marie Fertin; Renaud Fay; Christophe Bauters; Faïez Zannad; Florence Pinet; Patrick Rossignol
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-8-27
Journal Detail:
Title:  Circulation. Heart failure     Volume:  -     ISSN:  1941-3297     ISO Abbreviation:  Circ Heart Fail     Publication Date:  2013 Aug 
Date Detail:
Created Date:  2013-8-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101479941     Medline TA:  Circ Heart Fail     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1INSERM, Centre d'Investigation Clinique CIC-P 9501, Nancy; Clermont Université, Université d'Auvergne, UMR6284, CHU Clermont-Ferrand, Clermont-Ferrand, France.
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