Neprilysin levels at the acute phase of ST‐elevation myocardial infarction. Issue 1 (10th December 2018)

• Record Type: Journal Article
• Authors: Bernelin, Hugo; Mewton, Nathan; Si‐Mohamed, Salim; Croisille, Pierre; Rioufol, Gilles; Bonnefoy‐Cudraz, Eric; Douek, Philippe; Dufay, Nathalie; Amaz, Camille; Jossan, Claire; Ovize, Michel; Bochaton, Thomas
• Is Part Of: Clinical cardiology. Volume 42:Issue 1(2019)
• Page Start: 32
• Page End: 38
• Publication Date: 2018-12-10
• Subjects: CMR -- interleukine‐6 -- neprilysin -- STEMI; Cardiology -- Periodicals; 616.12005
• DOI: 10.1002/clc.23090
• Languages: English
• ISSNs: 0160-9289

Abstract

Abstract : 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.