CCN family member 1 (CCN1) is an early marker of infarct size and left ventricular dysfunction in STEMI patients. (October 2021)

• Record Type: Journal Article
• Authors: Mahendiran, Thabo; Klingenberg, Roland; Nanchen, David; Gencer, Baris; Meier, David; Räber, Lorenz; Carballo, David; Matter, Christian M.; Lüscher, Thomas F.; Mach, François; Rodondi, Nicolas; Muller, Olivier; Fournier, Stephane
• Is Part Of: Atherosclerosis. Volume 335(2021)
• Page Start: 77
• Page End: 83
• Publication Date: 2021-10
• Subjects: Acute coronary syndrome -- Biomarker -- Risk stratification; Arteriosclerosis -- Periodicals; Electronic journals; 616.136
• DOI: 10.1016/j.atherosclerosis.2021.09.019
• Languages: English
• ISSNs: 0021-9150

Abstract

Abstract: Background and aims: CCN family member 1 (CCN1) has recently been proposed as a novel biomarker of myocardial injury, improving prediction of 30-day and one-year mortality following acute coronary syndromes. Among ST-elevation myocardial infarction (STEMI) patients, we evaluated the utility of CCN1 measured immediately before primary percutaneous coronary intervention (PPCI) as a predictor of two earlier endpoints: final myocardial infarct size and post-infarction left ventricular ejection fraction (LVEF). Furthermore, we evaluated the impact of CCN1 on the discriminatory power of the CADILLAC score. Methods: STEMI patients were obtained from the SPUM-ACS cohort. Serum CCN1 was measured prior to PPCI. Linear regression assessed the association between CCN1, peak creatinine kinase (CK), and post-infarction LVEF. Cox models assessed an association between CCN1 and 30-day all-cause mortality. Results: CCN1 was measured in 989 patients with a median value of 706.2 ng/l (IQR 434.3–1319.6). A significant correlation between CCN1, myocardial infarct size (peak CK) and LVEF was observed in univariate and multivariate analysis (both p < 0.001). Even among patients with normal classical cardiac biomarker levels at the time of PPCI, CCN1 correlated significantly with final infarct size. CCN1 significantly improved prediction of 30-day all-cause mortality by the CADILLAC score (C-index 0.864, likelihood-ratio chi-square test statistic 6.331, p = 0.012; IDI 0.026, p= 0.050). Conclusions: Compared with classical cardiac biomarkers, CCN1 is potentially the earliest predictor of final myocardial infarct size and post-infarction LVEF. CCN1 improved the discriminatory capacity of the CADILLAC score suggesting a potential role in the very-early risk stratification of STEMI patients. Graphical abstract: Image 1 Highlights: CCN1 measured in STEMI patients prior to PPCI exhibits a significant correlation with final infarct size and LVEF. Even when classical cardiac biomarker levels are normal at the time of PPCI, CCN1 correlates with final infarct size. Addition of CCN1 to the CADILLAC score improves the prediction of 30-day all-cause mortality.