Open Access Highly Accessed Research article

Impact of percutaneous coronary intervention on biomarker levels in patients in the subacute phase following myocardial infarction: the Occluded Artery Trial (OAT) biomarker ancillary study

Mariusz Kruk1, Venu Menon2, Jacek Kądziela1, Zygmunt Sadowski1, Witold Rużyłło1, Jadwiga Janas1, Marek Roik3, Grzegorz Opolski3, Krzysztof Zmudka4, Piotr Czunko4, Michal Kurowski5, Benita Busz-Papież5, Elzbieta Zinka6, Wojciech Jablonski6, Krystyna Jaworska7, Anna Raczynska7, Grzegorz Skonieczny7, Sandra Forman8, Daner Li8 and Judith Hochman109*

Author Affiliations

1 Institute of Cardiology, Warsaw, Poland

2 Cleveland Clinic, Cleveland, Ohio, USA

3 Medical University, Warsaw, Poland

4 John Paul II Hospital, Krakow, Poland

5 County Hospital, Szczecin, Poland

6 County Hospital, Koszalin, Poland

7 County Hospital, Toruń, Poland

8 Clinical Trials and Surveys Corporation, Owings Mills, MD, USA

9 New York University School of Medicine, New York, New York, USA

10 Cardiovascular Clinical Research Center, Leon Charney Division of Cardiology, New York University School of Medicine, 530 First Ave, Skirball 9R, New York, NY 10016, USA

For all author emails, please log on.

BMC Cardiovascular Disorders 2013, 13:91  doi:10.1186/1471-2261-13-91

Published: 24 October 2013

Abstract

Background

The purpose of the Occluded Artery Trial (OAT) Biomarker substudy was to evaluate the impact of infarct related artery (IRA) revascularization on serial levels of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and dynamics of other biomarkers related to left ventricular remodeling, fibrosis and angiogenesis.

Methods

Patients were eligible for OAT-Biomarker based on the main OAT criteria. Of 70 patients (age 60.8 ± 8.8, 25% women) enrolled in the substudy, 37 were randomized to percutaneous coronary intervention (PCI) and 33 to optimal medical therapy alone. Baseline serum samples were obtained prior to OAT randomization with follow up samples taken at one year. The primary outcome was percent change of NT-proBNP from baseline to 1 year. The secondary outcomes were respective changes of matrix metalloproteinases (MMP) 2 and 9, tissue inhibitor of matrix metalloproteinase 2 (TIMP-2), Vascular Endothelial Growth Factor (VEGF), and Galectin-3.

Results

Paired (baseline and one-year) serum samples were obtained in 62 subjects. Baseline median NT-proBNP level was 944.8 (455.3, 1533) ng/L and decreased by 69% during follow-up (p < 0.0001). Baseline MMP-2 and TIMP-2 levels increased significantly from baseline to follow-up (p = 0.034, and p = 0.027 respectively), while MMP-9 level decreased from baseline (p = 0.038). Levels of VEGF and Galectin-3 remained stable at one year (p = NS for both). No impact of IRA revascularization on any biomarker dynamics were noted.

Conclusions

There were significant changes in measured biomarkers related to LV remodeling, stress, and fibrosis following MI between 0 and 12 month. Establishing infarct vessel patency utilizing stenting 24 hours-28 days post MI did not however influence the biomarkers’ release.

Keywords:
Acute coronary syndrome; Percutaneous coronary intervention; Biomarkers; Heart failure; Remodeling