Adverse interaction between HDL and the mass of myocardial infarction. (February 2019)

• Record Type: Journal Article
• Authors: Soares, Alexandre A.S.; Carvalho, Luiz Sergio F.; Bonilha, Isabella; Virginio, Vitor W.; Nadruz Junior, Wilson; Coelho-Filho, Otavio Rizzi; Quinaglia e Silva, Jose C.; Petrucci Junior, Orlando; Sposito, Andrei C.
• Is Part Of: Atherosclerosis. Volume 281(2019)
• Page Start: 9
• Page End: 16
• Publication Date: 2019-02
• Subjects: Myocardial infarction -- High-density lipoprotein -- Ischemia-reperfusion injury -- Cardiac magnetic resonance -- MB creatine kinase; Arteriosclerosis -- Periodicals; Electronic journals; 616.136
• DOI: 10.1016/j.atherosclerosis.2018.12.002
• Languages: English
• ISSNs: 0021-9150

Abstract

Abstract: Background and aims: Coronary reperfusion with HDL from healthy volunteers attenuates ischemia and reperfusion injury in animal models. In myocardial infarction (MI) patients, such an interaction is unclear. Hence, our first objective was to verify if there is interaction between HDL-C and MI mass in patients and the role of coronary reperfusion in the interaction. Furthermore, we investigated whether the effect in MI size of reperfusion with HDL obtained from healthy participants or MI patients could differ. Methods: HDL-C was measured the first day after MI and MI mass was quantified by cardiac magnetic resonance (n = 94) and peak CKMB (n = 393). In an ex vivo rat heart model, we compared MI area and dP/dt max after coronary reperfusion with HDL from MI patients or healthy volunteers. Results: HDL-C above the median (35 mg/dL) was associated with higher peak CKMB [255 (145–415) vs. 136 (84–287) UI/L; p = 0.02], higher MI mass [17 (9–21) vs. 10 (6–14) g; p < 0.01] and lower left ventricular ejection fraction [47 (34–53) vs. 51 (43–59); p = 0.02] than their counterparts. In restricted cubic spline and multivariate linear regression, HDL-C was directly associated with peak CKMB ( p < 0.01) and MI mass ( p < 0.01) only in reperfused patients with time to reperfusion <4 h. Reperfusion with healthy HDL, but not from MI patients, reduced MI mass ( p < 0.01) and improved dP/dt max ( p = 0.02). Conclusions: In MI patients undergoing early coronary reperfusion, HDL-C levels at admission are directly associated with MI size. In contrast to healthy HDL, reperfusion with HDL from MI patients do not reduce MI area in an ex vivo animal model. Graphical abstract: Image 1 Highlights: Higher HDL-C levels on first day of ST-segment elevation MI predict larger MI mass. HDL-C predicts MI mass assessed by cardiac magnetic resonance or CKMB enzymatic curve. The interaction between HDL-C and MI mass depends on early (<4 h) coronary reperfusion. Healthy HDL infused during reperfusion in an ex vivo animal model reduces MI size. HDL from MI patients fail to reduce MI size in the same model.