Open AccessNeprilysin levels at the acute phase of ST‐elevation myocardial infarction
Author(s) -
Bernelin Hugo,
Mewton Nathan,
SiMohamed Salim,
Croisille Pierre,
Rioufol Gilles,
BonnefoyCudraz Eric,
Douek Philippe,
Dufay Nathalie,
Amaz Camille,
Jossan Claire,
Ovize Michel,
Bochaton Thomas
Publication year - 2019
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.23090
Subject(s) - interquartile range , medicine , ejection fraction , myocardial infarction , cardiology , hazard ratio , percutaneous coronary intervention , confidence interval , neprilysin , creatine kinase , troponin , prospective cohort study , heart failure , enzyme , biochemistry , chemistry
Background Several preliminary analyses suggested an association between neprilysin (NEP) levels and myocardial infarction. Hypothesis The objective was to assess whether NEP plasma levels following reperfusion might be a surrogate for infarct size (IS) or predict adverse outcomes in acute ST‐segment elevation myocardial infarction ( STEMI) patients. Methods We measured NEP levels in a prospective cohort of 203 patients with STEMI referred for primary percutaneous coronary intervention. Circulating soluble NEP was measured by enzyme‐linked immunosorbent assay at admission (t0) and 4 hours later (t4) following reperfusion and on 7 times points (t0, t4, t12, t24, t48, day 7 and day 30) in a subset of 21 patients. IS and left ventricular ejection fraction (LVEF) were measured at 1 month by cardiac magnetic resonance. Adverse cardiovascular outcomes were collected at 12‐month follow‐up. Results Median t0 and t4 NEP levels in 203 patients were respectively 88.3 pg/mL (interquartile range [IQR] [14; 375.4]) and 101.5 pg/mL (IQR [18.5; 423.8]). These levels remained unchanged over 1 month ( P = 0.70). NEP levels did not correlate significantly with IS ( P = 0.51) or LVEF ( P = 0.34). There was no correlation between NEP and troponin, creatine kinase and interleukin‐6 levels at h0 and h4. NEP levels above the median were not associated with adverse outcomes at follow‐up (hazard ratio = 1.28, 95% confidence interval [0.69; 2.37]; P = 0.42). Conclusions NEP serum levels were widely distributed and did not change significantly in the first hours and 1‐month period following reperfusion in STEMI patients. There was no significant relationship with markers of infarct size and inflammation, and 1‐year adverse outcomes.