Biomarker concentrations and their temporal changes in patients with myocardial infarction and nonobstructive compared with obstructive coronary arteries

• Verfasst von: Hjort, Marcus [VerfasserIn]
• Verfasst von: Eggers, Kai M. [VerfasserIn]
• Verfasst von: Lakic, Tatevik Ghukasyan [VerfasserIn]
• Verfasst von: Lindbäck, Johan [VerfasserIn]
• Verfasst von: Budaj, Andrzej [VerfasserIn]
• Verfasst von: Cornel, Jan Hein [VerfasserIn]
• Verfasst von: Giannitsis, Evangelos [VerfasserIn]
• Verfasst von: Katus, Hugo [VerfasserIn]
• Verfasst von: Siegbahn, Agneta [VerfasserIn]
• Verfasst von: Storey, Robert [VerfasserIn]
• Verfasst von: Becker, Richard C. [VerfasserIn]
• Verfasst von: Wallentin, Lars [VerfasserIn]
• Verfasst von: Lindahl, Bertil [VerfasserIn]
• Titel: Biomarker concentrations and their temporal changes in patients with myocardial infarction and nonobstructive compared with obstructive coronary arteries
• Titelzusatz: results from the PLATO trial
• Verf.angabe: Marcus Hjort, Kai M. Eggers, Tatevik Ghukasyan Lakic, Johan Lindbäck, Andrzej Budaj, Jan H. Cornel, Evangelos Giannitsis, Hugo A. Katus, Agneta Siegbahn, Robert F. Storey, Richard C. Becker, Lars Wallentin, Bertil Lindahl; the PLATO trial investigators
• Jahr: 2023
• Umfang: ?
• Illustrationen: Illustrationen
• Fussnoten: Gesehen am 13.06.2023 ; published online december 24, 2022
• Titel Quelle: Enthalten in: American Heart AssociationJournal of the American Heart Association
• Ort Quelle: New York, NY : Association, 2012
• Jahr Quelle: 2023
• Band/Heft Quelle: 12(2023), 1 vom: Jan., Artikel-ID e027466
• ISSN Quelle: 2047-9980
• DOI: doi:10.1161/JAHA.122.027466
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: biomarkers
• Sach-SW: myocardial infarction
• Sach-SW: myocardial infarction with nonobstructive coronary arteries
• Sach-SW: pathophysiology
• K10plus-PPN: 184887491X

Abstract

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. - - Registration - - URL: http://www.clinicaltrials.gov; Unique identifier: NCT00391872.