High levels of stromal cell-derived factor-1α predict secondary cardiac events in stable patients with a history of myocardial infarction. Issue 1 (January 2017)

• Record Type: Journal Article
• Authors: Matsuoka, Satoshi; Uematsu, Manabu; Nakamura, Takamitsu; Shimizu, Takuya; Futamata, Mika; Obata, Jun-ei; Fujioka, Daisuke; Nakamura, Kazuto; Yoshizaki, Toru; Kugiyama, Kiyotaka
• Is Part Of: Journal of cardiology. Volume 69:Issue 1(2017:Jan.)
• Page Start: 320
• Page End: 325
• Publication Date: 2017-01
• Subjects: Stromal cell-derived factor-1α -- Myocardial infarction -- Prognosis -- Cardiac events -- Inflammatory marker; Cardiology -- Periodicals; 616.12
• DOI: 10.1016/j.jjcc.2016.06.011
• Languages: English
• ISSNs: 0914-5087

Abstract

Abstract: Background: We recently showed that stromal cell-derived factor (SDF)-1α, a pro-inflammatory mediator, is produced in infarcted myocardium and is associated with left ventricular (LV) adverse remodeling and progressive dysfunction following acute myocardial infarction (AMI). The current study examined whether SDF-1α levels in the peripheral vein can provide prognostic information of outcomes in stable patients with a history of MI. Methods: Plasma levels of SDF-1α in the peripheral vein were measured by enzyme-linked immunosorbent assay in 192 stable patients with a history of MI. All patients were followed prospectively for a period of 90 months or until occurrence of one of the following cardiac events: cardiac death, non-fatal myocardial infarction, unstable angina requiring unplanned coronary revascularization, or worsening heart failure requiring hospital admission. Results: During the follow-up period (77 ± 26 months), 30 patients had cardiac events. Multivariate Cox analysis revealed that high levels of SDF-1α (≥2162 pg/mL; a cut-off value determined by receiver-operating characteristic analysis) were a significant predictor of cardiac events, independent of traditional risk factors (HR: 1.98; 95% CI: 1.38–2.85; p < 0.001). The addition of high levels of SDF-1α to conventional risk factors including brain natriuretic peptide improved net reclassification improvement (NRI) and integrated discrimination improvement (IDI) (NRI 0.90, p < 0.0001; and IDI 0.05, p = 0.002). Conclusions: High levels of SDF-1α predicted secondary cardiac events in stable patients with a history of MI. SDF-1α levels may be a useful risk assessment tool in patients with a history of MI.