Document Detail


Usefulness of intraplatelet melatonin levels to predict angiographic no-reflow after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction.
MedLine Citation:
PMID:  21094352     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Platelet aggregates appear to have a pathogenic role in the no-reflow phenomenon, which is associated with impaired clinical outcome in patients with ST-segment elevation myocardial infarction (STEMI). Melatonin, a hormone that plays a major role in biological circadian rhythms, is present in human platelets. Lowered circulating melatonin levels predict poor outcome in patients with STEMI undergoing primary percutaneous coronary intervention (PPCI). We investigated whether intraplatelet melatonin levels correlate with angiographic no-reflow after PPCI in patients with STEMI. We studied 180 consecutive patients with a first STEMI who underwent PPCI within 6 hours from onset of symptoms. Intraplatelet melatonin levels were measured in platelet-rich plasma using an enzymatic immunoassay method. After PPCI, angiographic no-reflow (defined as Thrombolysis In Myocardial Infarction grade < 2 flow) was observed in 63 patients (35%). Patients with angiographic no-reflow had lower intraplatelet melatonin levels compared to patients without no-reflow (12.32 ± 3.64 vs 18.62 ± 3.88 ng/100,000 platelets, p < 0.0001). After adjusting by potential confounders, binary logistic regression analysis showed that intraplatelet melatonin levels were the only significant predictor of angiographic no-reflow (odds ratio 1.58, 95% confidence interval 1.37 to 1.82, p < 0.0001). In conclusion, low intraplatelet melatonin concentration predicts angiographic no-reflow after PPCI in patients with STEMI.
Authors:
Alberto Dominguez-Rodriguez; Pedro Abreu-Gonzalez; Alejandro Jimenez-Sosa; Pablo Avanzas; Francisco Bosa-Ojeda; Juan Carlos Kaski
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-10-14
Journal Detail:
Title:  The American journal of cardiology     Volume:  106     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2011-01-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1540-4     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiology, Hospital Universitario de Canarias, Tenerife, Spain. adrvdg@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Balloon, Coronary*
Biological Markers / metabolism
Blood Platelets / metabolism*
Coronary Angiography*
Coronary Circulation / physiology*
Electrocardiography*
Female
Follow-Up Studies
Humans
Male
Melatonin / metabolism*
Middle Aged
Myocardial Infarction / blood*,  radiography,  therapy
No-Reflow Phenomenon / blood
Odds Ratio
Prognosis
Treatment Outcome
Chemical
Reg. No./Substance:
0/Biological Markers; 73-31-4/Melatonin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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