P204Power value of circulating stromelysin-1 as a possible marker of cardiovascular remodelling in patients after myocardial infarction

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Abstract

Background

Not all obesity patients after myocardial infarction with chronic heart failure respond to conventionally treatment (CT) are equale. Traditionally, NT-pro-brain natriuretic peptide (BNP) variations could be useful in predicting the therapeutic efficacy of CT. However, it has been considered some limitations for predicting value of NT-pro-BNP concentrations among obesity patients population. Circulating stromelysin-1 has been proposed as a possible marker of severity of cardiovascular remodelling and survival ratio afteracute myocardial infarction. Prognostic power of stromelysin-1 levels in predicting clinical outcomes regarding mentioned above has been hampered by inconsistent results.

Aim

To evaluate value for 6 months survival of circulating stromelysin-1 plasma level in comparison to NT-pro-BNP concentration in obesity patients with chronic heart failure after myocardial infarction.

Methods

68 patients (52 male, 46-62 aged) after Q-wave myocardial infarction with mild-to-moderate chronic heart failure (CHF) and left ventricular ejection fraction (LVEF) less 50% were studied prospectively for 6 months regarding survival. Both circulating stromelysin-1 plasma levels and NT-pro-BNP were measured at the study entry by ELISA.

Results

Myocardial infarction subjects were divided into groups according to whether (n = 29) or not (n = 39) they appeared conventional obesity criteria. LVEF and mean value of NYHA functional class of CHF were similar in both groups. Six month survival rate was 86.2 % and 87.1% for both group subjects respectively. However, the mean NT-pro-BNP plasma levels were significantly lower in dead patients with obesity in comparison to subjects without of one. At the same time, circulating stromelysin-1 plasma levels in both dead group patients not only were the same, but the values were significantly lower in survival subjects independently they appeared obesity criteria.

Conclusions

We proposed that circulating stromelysin-1 plasma level might have more predicting value in comparison with traditionally measured NT-pro-BNP concentration among obesity population after myocardial infarction. The role of circulating stromelysin-1 plasma level as a prognostic indicator for obesity patients with CHF after myocardial infarction can be discussed.

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