The role of macrophage migration inhibitory factor in predicting left ventricular remodeling in patients with acute myocardial infarction

2021 ◽  
Author(s):  
T. Y. Storozhenko ◽  
M. P. Kopytsya ◽  
I. R. Vishnevska ◽  
L. L. Pietienova
Keyword(s):  
Myocardial Infarction ◽  
Migration Inhibitory Factor ◽  
Macrophage Migration Inhibitory Factor ◽  
Left Ventricular ◽  
Macrophage Migration ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Lv Remodeling

Objective — to assess the role of circulating markers of inflammation and macrophage migration inhibitory factor (MIF) in the development of left ventricular (LV) remodeling 6 months after acute ST‑segment elevation myocardial infarction (STEMI). Materials and methods. The study involved 120 patients after STEMI and successful primary percutaneous coronary intervention (PCI). Transthoracic echocardiography with Doppler was performed within 24 — 48 hours after PCI and after 6 months of follow‑up to assess LV remodeling. The levels of MIF and inflammatory markers were measured before and after PCI. All patients were divided into two groups according to the median MIF level < 2501 pg/ml (first group, n = 60) and > 2501 pg/ml (second group, n = 60). Results. Patients with the high levels of circulating MIF had a higher frequency of complications in the hospital and long‑term periods (p = 0.024), including newly diagnosed heart failure or decompensation with hospitalizations. High MIF levels in patients of the second group were accompanied by a significant enlargement of end‑diastolic and end‑systolic LV volumes (p = 0.028; p = 0.031, respectively), the development of secondary mitral regurgitation (p = 0.024) and decreased LV systolic function (p = 0.037). MIF threshold values for predicting remodeling > 2694 pg/ml (sensitivity 69.2 %, specificity 71.4 %, AUC = 0.714; 95 % CI  0.509 — 0.870; p = 0.0375) and LV dysfunction > 2484 pg/ml (sensitivity 90.0 %, specificity 58.0 %, AUC = 0.782; 95 % CI  0.675 — 0.867, p = 0.0003) were determined using ROC analysis. According to the results of univariate and multivariate analysis, levels of MIF (p = 0.028) and soluble suppressor of tumorigenesis‑2 (p = 0.042) were most significant predictors of LV remodeling. A correlation between the levels of MIF and white blood cells count (r = 0.33, p = 0.0001), C‑reactive protein (r = 0.19, p = 0.032), troponin (r = 0.44, p = 0.002) has been established. Conclusions. An early increase of MIF levels is associated with the development of adverse structural and functional changes in left ventricle of patients after acute ST‑segment elevation myocardial infarction.

scholarly journals The biomarker macrophage migration inhibitory factor as a predictor of no-reflow phenomenon and other adverse events in patients with ST-segment elevation myocardial infarction

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
I Vishnevskaya ◽  
M P Kopytsya ◽  
T Y E Storozhenko
Keyword(s):  
Myocardial Infarction ◽  
Blood Flow ◽  
Migration Inhibitory Factor ◽  
Macrophage Migration Inhibitory Factor ◽  
Macrophage Migration ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
No Reflow ◽  
St Segment ◽  
No Reflow Phenomenon

Abstract   Major adverse cardiovascular events (MACE) in patients with ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI) may be caused by the “no-reflow” phenomenon. Biomarkers for the “no-reflow” phenomenon prediction is being actively studied. Proinflammatory cytokine macrophage migration inhibitory factor (MIF) is one of the promising biomarkers. Purpose To estimate the role of MIF in the prediction of early reperfusion myocardial injury and MACE in patients with STEMI. Methods The study involved 341 STEMI patients (78.6% male and 21.4% female) with an average age of 59.08±9.65 years. Control group of 12 healthy volunteers included. All patients were made to undergo a baseline investigation. In addition, the level of MIF and soluble suppression of tumorigenicity-2 (sST2) determined twice during the first 12 hours of STEMI, before the PCI and 24 hours after the procedure. Coronary blood flow evaluated using TIMI flow grade and myocardial blush grade (MBG). All patients had epicardial blood flow TIMI 3. The criteria for “no-reflow” diagnosis were myocardial perfusion at MBG 0 or MBG 1 level with complete recovery of epicardial blood flow or ST-segment resolution (rST) of less than 70% from baseline within 2 hours after PCI. All patients were divided into two groups according to MBG and rST after PCI more and less than 70%: 147 patients in the first group with MBG stage 0–1, 182 patients with MBG stage 2–3. Results The level of MIF biomarker determined before PCI was significantly higher in the group of patients with MBG 0–1 in comparison to MBG 2–3. (4386,750±676 pg/ml vs 2935±350 pg/ml; p=0,05). Also, the level of sST2, left ventricular mass index and blood glucose were significantly higher in the group of MBG 0–1 (p=0.03, p=0.006 and p=0.0085, respectively). The difference in left ventricle posterior wall thickness and early to late diastolic transmitral flow velocity (p=0.045) was found between two groups. In the group of MBG 0–1 and rST&lt;70% these parameters were significantly lower (p=0,04 and p=0,05, respectively). Using the multivariate regression analysis, the dependency of the biomarker MIF on the parameters of the reperfusion myocardial injuries were obtained. MIF measured before revascularization was an independent predictor of MBG 0–1 and rST less than 70% (coefficients Beta 0,00057; odd ratio 1,0; 95%confidential interval (CI) 1,0–1,001; p=0,038). The Kaplan-Meier survival analysis showed that long-term adverse outcomes rate after STEMI was significantly higher in patient with the level of MIF determined during the first 12 hours after the event more than 2988 pg/ml (Log-rank = −4,891, p=0.014). Conclusions Biomarkers MIF has a capacity as predictive tool for MACE and “no-reflow” phenomenon in STEMI patients. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Macrophage Migration Inhibitory Factor Levels Predict No-reflow in ST-segment Elevation Myocardial Infarction.

Pharmacophore ◽  
2021 ◽  
Vol 12 (4) ◽  
pp. 56-67
Author(s):  
Tatyana Yevgenyevna Storozhenko ◽  
Irina Ruslanovna Vishnevskaya ◽  
Mykola Pavlovich Kopytsya ◽  
Alexander Evgenyevich Berezin
Keyword(s):  
Myocardial Infarction ◽  
Migration Inhibitory Factor ◽  
Macrophage Migration Inhibitory Factor ◽  
Inhibitory Factor ◽  
Macrophage Migration ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
No Reflow ◽  
St Segment

P6604Role of macrophage migration inhibitory factor and early after infarction remodeling in patients with ST-segment elevation myocardial infarction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T E Storozhenko ◽  
M P Kopytsya ◽  
I R Vyshnevska ◽  
O V Petyunina
Keyword(s):  
Myocardial Infarction ◽  
Left Ventricle ◽  
Migration Inhibitory Factor ◽  
Cardiac Remodeling ◽  
Macrophage Migration Inhibitory Factor ◽  
Inhibitory Factor ◽  
Macrophage Migration ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Abstract A heart failure formation in patients with ST-segment elevation myocardial infarction (STEMI) is the most often adverse outcome and determined by early cardiac remodeling. One of the promising biomarkers for the early diagnosis of cardiac remodeling is proinflammatory cytokine macrophage migration inhibitory factor (MIF). Purpose estimate the role of MIF in the prediction of early cardiac remodeling in patients with STEMI. Methods The study involved 73 STEMI patients (72.6% male and 27.4% female) with an average age of 58.25±10.45 years. Control group of 12 healthy volunteers included. All patients were made to undergo a baseline investigation. In addition, the level of MIF determined during the first 12 hours of STEMI and before the percutaneous coronary intervention. Results 64% of STEMI patients had elevated MIF levels above the highest value in healthy controls (2778±217 ng/ml; 225±6,7 ng/ml; p=0,0003). Using the linear regression analysis, the dependences of the biomarker MIF on the parameters of the left ventricle end-diastolic volume and the left ventricle end-systolic volume obtained (dependent variables, standardized coefficients beta −1.1; p=0.001 and 0.6; p=0.02, respectively). Conclusions STEMI patients with higher MIF concentration associated with more pronounced changes in heart geometry during the acute period. Further investigations of the MIF biological effects are the perspective direction in the development of prevention and treatment of STEMI.

A macrophage migration inhibitory factor as a predictor of reperfusion myocardial injury in patients with st-segment elevation myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
I Vishnevskaya ◽  
T.Y.E Storozhenko ◽  
M.P Kopytsya
Keyword(s):  
Myocardial Infarction ◽  
Blood Flow ◽  
Macrophage Migration Inhibitory Factor ◽  
Myocardial Injury ◽  
Macrophage Migration ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
No Reflow ◽  
St Segment ◽  
No Reflow Phenomenon

Abstract Introduction Major adverse cardiovascular events in patients with ST-segment elevation myocardial infarction (STEMI) are still common despite the modern treatment approaches. It may be caused by the “no-reflow” phenomenon. One of the promising biomarkers for the coronary “no-reflow” phenomenon prediction is proinflammatory cytokine macrophage migration inhibitory factor (MIF). Purpose To estimate the role of MIF in the prediction of early reperfusion myocardial injury in patients with STEMI. Methods The study involved 341 STEMI patients (78.6% male and 21.4% female) with an average age of 59.08±9.65 years. Control group of 12 healthy volunteers included. All patients were made to undergo a baseline investigation. In addition, the level of MIF determined twice during the first 12 hours of STEMI, before the percutaneous coronary intervention (PCI) and after the procedure. Coronary blood flow evaluated using TIMI flow grade and myocardial blush grade (MBG). All patients had epicardial blood flow TIMI 3. The criteria for “no-reflow” diagnosis were myocardial perfusion at MBG 0 or MBG 1 level with complete recovery of epicardial blood flow or ST-segment resolution (rST) of less than 70% from baseline within 2 hours after PCI. All patients were divided into two groups according to MBG and rST after PCI more and less than 70%: 147 patients in the first group with MBG stage 0–1, 182 patients with MBG stage 2–3 Results 64% of STEMI patients had elevated MIF levels above the highest value in healthy controls (2778±217 ng/ml; 225±6,7 ng/ml; p=0,0003). The level of MIF biomarker, determined before PCI was significantly higher in the group of patients with MBG 0–1 in comparison to MBG 2–3. (4708±471 ng/ml vs 2914±347ng/ml; p=0,004). Using the multivariate regression analysis, the dependencies of the biomarker MIF on the parameters of the reperfusion myocardial injuries were obtained. MIF measured before revascularization as well as the patient's gender, was an independent predictor of MBG 0–1 and rST less than 70% (coefficients Beta 0,1; odd ratio 1,1; 95%confidential interval (CI) 1,0–1,2; p=0,037 and coefficient Beta 2,9; odd ratio 17.7; 95% CI 0,96–32; p=0,05, respectively). Conclusions The study revealed that MIF predicts reperfusion myocardial injury in patients with STEMI. Future investigations of the MIF biological effects are the perspective direction in the field of modern cardiology. Funding Acknowledgement Type of funding source: None

Novel role of platelet reactivity in adverse left ventricular remodelling after ST-segment elevation myocardial infarction: The REMODELING Trial

2017 ◽  
Vol 117 (05) ◽  
pp. 911-922 ◽  
Author(s):  
Yongwhi Park ◽  
Udaya Tantry ◽  
Jin-Sin Koh ◽  
Jong-Hwa Ahn ◽  
Min Kang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Platelet Reactivity ◽  
Left Ventricular ◽  
Ventricular Remodelling ◽  
Left Ventricular Remodelling ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Hs Crp

SummaryThe role of platelet-leukocyte interaction in the infarct myocardium still remains unveiled. We aimed to determine the linkage of platelet activation to post-infarct left ventricular remodelling (LVR) process. REMODELING was a prospective, observational, cohort trial including patients (n = 150) with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention. Patients were given aspirin plus clopidogrel therapy (600 mg loading and 75 mg daily). Platelet reactivity (PRU: P2Y12 Reaction Units) was assessed with VerifyNow P2Y12 assay on admission. Transthoracic echocardiography was performed on admission and at one-month follow-up. The primary endpoint was the incidence of LVR according to PRU-based quartile distribution. LVR was defined as a relative ≥ 20 % increase in LV end-diastolic volume (LVEDV) between measurements. Adverse LVR was observed in 36 patients (24.0 %). According to PRU quartile, LVR rate was 10.8 % in the first, 23.1 % in the second, 27.0 % in the third, and 35.1 % in the fourth (p = 0.015): the optimal cut-off of PRU was ≥ 248 (area under curve: 0.643; 95 % confidence interval: 0.543 to 0.744; p = 0.010). LVR rate also increased proportionally according to the level of high sensitivity-C reactive protein (hs-CRP) (p = 0.012). In multivariate analysis, the combination of PRU (≥ 248) and hs-CRP (≥ 1.4 mg/l) significantly increased the predictive value for LVR occurrence by about 21-fold. In conclusion, enhanced levels of platelet activation and inflammation determined the incidence of adverse LVR after STEMI. Combining the measurements of these risk factors increased risk discrimination of LVR. The role of intensified antiplatelet or anti-inflammatory therapy in post-infarct LVR process deserves further study.

scholarly journals The predictive power of biomarker macrophage migration inhibitory factor in patients with st- segment elevation myocardial infarction

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
I Vishnevskaya ◽  
M P Kopytsya ◽  
T Y E Storozhenko
Keyword(s):  
Myocardial Infarction ◽  
Adverse Events ◽  
Macrophage Migration Inhibitory Factor ◽  
Adverse Outcome ◽  
Adverse Outcomes ◽  
Macrophage Migration ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Abstract   Biomarkers have been taken one of the first places as diagnostic and prognostic tools in acute myocardial infarction (AMI). They are used both in the acute and in the long-term periods of the disease to predict various adverse events Their especially important property is the ability to predict the long-term adverse events of the disease, which can significantly improve the outcome. One of the promising biomarkers for the early adverse outcome prediction is the proinflammatory cytokine macrophage migration inhibitory factor (MIF). Purpose To determine the MIF significance in 1-year adverse outcomes prognosis after AMI. Methods 130 ST-segment elevation myocardial infarction (STEMI) patients (72.6% male and 27.4% female) were enrolled, mean age was 58.25±1.22 years. Control group of 12 healthy volunteers included. All patients underwent a baseline investigation which includes standard electrocardiography, echocardiography with strain, angiography, and determination of marker of myocardial necrosis – cardiac troponin T. Also, the level of MIF, soluble suppression of tumorigenicity-2 (sST2), C-reactive protein determined during the first 12 hours after the STEMI, before the percutaneous coronary intervention (PCI), 6 hours, and 24 hours after the PCI. The endpoint was composite and included all-cause mortality, nonfatal myocardial infarction, nonfatal stroke, and hospitalization for unstable angina, acute decompensated heart failure. During 1-year follow-up 18% of patients reached the endpoint. Results The effect of several variables of clinical, instrumental and laboratory status were assessed on reaching the endpoint by patients. We have found that MIF level determined before PCI (AUC 0.73; p=0.003; 95% Cl: 0.613 – 0.826) might be a significant independent predictor of mortality with sensitivity (Se) 70% and specificity (Sp) 80%. MIF level 6 hours after PCI showed even better result (AUC 0.8; p=0.002; 95% Cl: 0.64 – 0.9; Se 74%, Sp 82%). MIF &gt;3934 pg/ml associated with the highest risk of adverse events. For identification of the main risk factors for adverse outcome, we have used logistic regression method. The MIF level determined before the PCI was the most important to predict adverse outcomes (odds ratios is 1.0006, p=0,0038; x2=4.58). Areas under the ROC for the model was equal to 0.8; 95% Cl: 0.58 to 0.89). Neither sST2 nor CRP have not shown any significant results (p&lt;0.05). According to the data of the Kaplan-Meier survival analysis, long-term survival after STEMI was significantly lower in patient with the level of MIF determined during the first 12 hours after the event more than 2988 pg/ml (Log-rank = −4,891, p=0.014). Conclusions Biomarker MIF has showed as an independent tool associated with the risk of adverse outcome 1 year after STEMI. MIF could be used in routine clinical practice to improve risk stratification of patients with STEMI. FUNDunding Acknowledgement Type of funding sources: None.

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