Features of metabolic syndrome and inflammation independently affect left ventricular function early after first myocardial infarction. (1st January 2023)

• Record Type: Journal Article
• Authors: Traub, Jan; Schürmann, Paula; Schmitt, Dominik; Gassenmaier, Tobias; Fette, Georg; Frantz, Stefan; Störk, Stefan; Beyersdorf, Niklas; Boivin-Jahns, Valérie; Jahns, Roland; Hofmann, Ulrich; Frey, Anna
• Is Part Of: International journal of cardiology. Volume 370(2023)
• Page Start: 43
• Page End: 50
• Publication Date: 2023-01-01
• Subjects: STEMI -- Metabolic syndrome -- Inflammation -- Remodeling -- Ejection fraction; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2022.10.142
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: A high body mass index (BMI) is often associated with metabolic syndrome, which is accompanied by systemic low-grade chronic inflammation. Here, we analyzed whether BMI, other components of metabolic syndrome, and/or inflammatory markers correlate with left ventricular geometry, function, and infarct size as assessed by serial cardiac magnetic resonance imaging (MRI) after a first (clinically evident) ST-elevation MI (STEMI). Methods: Within the Etiology, Titre-Course, and effect on Survival (ETiCS) study, cardiac MRI conducted 7–9 days and 12 months after MI enabled longitudinal characterization of patients with a first STEMI along with serial routine blood counts and multiplex cytokine measurements. Results: Of 91 locally included STEMI patients, 47% were overweight (25 kg/m 2 < BMI < 30 kg/m 2 ) and 24% were obese (BMI ≥ 30 kg/m 2 ). No patient died during 12 months of follow-up. Left ventricular ejection fraction (LVEF), measured 7–9 days after STEMI, was significantly lower in overweight (49.5 ± 7.1%) and obese (45.8 ± 12.0%) patients than in the normal weight group (56.2 ± 7.7%). Along with BMI (T = -3.8; p < 0.001), hemoglobin A1c (HbA1c; T = -3.1; p = 0.004) and peak C-reactive protein (T = -2.6; p = 0.013) emerged as independent predictors of worse LVEF 7–9 days post MI (R 2 = 0.45). Only peak C-reactive protein (T = -4.4; p < 0.001), but not parameters of the metabolic syndrome, predicted worse LVEF 12 months after STEMI (R 2 = 0.20). Conclusion: Both BMI and HbA1c correlated negatively with LVEF only early, but not late after STEMI. Peak CRP evolved as strongest predictor of cardiac function at all time points independent of the metabolic syndrome. Highlights: Body mass index and HbA1c correlate negatively with ejection fraction early after myocardial infarction Peak C-reactive protein independently associates with lower ejection fraction at all time points The differential role of inflammation needs to be investigated further via a preclinical approach