Association of Angiotensin II Receptor Type 1 and Endothelin-1 Receptor Type A Agonistic Autoantibodies With Adverse Remodeling and Cardiovascular Events After Acute Myocardial Infarction.

Autor: Tona F; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health University of Padua Padua Italy., Civieri G; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health University of Padua Padua Italy., Vadori M; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health University of Padua Padua Italy., Masiero G; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health University of Padua Padua Italy., Iop L; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health University of Padua Padua Italy., Marra MP; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health University of Padua Padua Italy., Perin V; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health University of Padua Padua Italy., Cuciz E; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health University of Padua Padua Italy., Cecere A; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health University of Padua Padua Italy., Bernava G; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health University of Padua Padua Italy., Tansella D; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health University of Padua Padua Italy., Naumova N; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health University of Padua Padua Italy., Grewal S; Penn State Hershey Medical Center Hershey PA USA., Cozzi E; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health University of Padua Padua Italy., Iliceto S; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health University of Padua Padua Italy.
Jazyk: angličtina
Zdroj: Journal of the American Heart Association [J Am Heart Assoc] 2024 Feb 20; Vol. 13 (4), pp. e032672. Date of Electronic Publication: 2024 Feb 13.
DOI: 10.1161/JAHA.123.032672
Abstrakt: Background: The left ventricular remodeling (LVR) process has limited the effectiveness of therapies after myocardial infarction. The relationship between autoantibodies activating AT1R-AAs (angiotensin II receptor type 1-AAs) and ETAR-AAs (autoantibodies activating endothelin-1 receptor type A) with myocardial infarction has been described. Among patients with ST-segment-elevation myocardial infarction, we investigated the relationship between these autoantibodies with LVR and subsequent major adverse cardiac events.
Methods and Results: In this prospective observational study, we included 131 patients with ST-segment-elevation myocardial infarction (61±11 years of age, 112 men) treated with primary percutaneous coronary intervention. Within 48 hours of admission, 2-dimensional transthoracic echocardiography was performed, and blood samples were obtained. The seropositive threshold for AT1R-AAs and ETAR-AAs was >10 U/mL. Patients were followed up at 6 months, when repeat transthoracic echocardiography was performed. The primary end points were LVR, defined as a 20% increase in left ventricular end-diastolic volume index, and major adverse cardiac event occurrence at follow-up, defined as cardiac death, nonfatal re-myocardial infarction, and hospitalization for heart failure. Forty-one (31%) patients experienced LVR. The prevalence of AT1R-AAs and ETAR-AAs seropositivity was higher in patients with versus without LVR (39% versus 11%, P <0.001 and 37% versus 12%, P =0.001, respectively). In multivariable analysis, AT1R-AAs seropositivity was significantly associated with LVR (odds ratio [OR], 4.66; P =0.002) and represented a risk factor for subsequent major adverse cardiac events (OR, 19.6; P =0.002).
Conclusions: AT1R-AAs and ETAR-AAs are associated with LVR in patients with ST-segment-elevation myocardial infarction. AT1R-AAs are also significantly associated with recurrent major adverse cardiac events. These initial observations may set the stage for a better pathophysiological understanding of the mechanisms contributing to LVR and ST-segment-elevation myocardial infarction prognosis.
Databáze: MEDLINE
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