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2018 ; 5
(3
): 292-301
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Acute heart failure following myocardial infarction: complement activation
correlates with the severity of heart failure in patients developing cardiogenic
shock
#MMPMID29424484
Orrem HL
; Nilsson PH
; Pischke SE
; Grindheim G
; Garred P
; Seljeflot I
; Husebye T
; Aukrust P
; Yndestad A
; Andersen GØ
; Barratt-Due A
; Mollnes TE
ESC Heart Fail
2018[Jun]; 5
(3
): 292-301
PMID29424484
show ga
AIMS: Heart failure (HF) is an impending complication to myocardial infarction.
We hypothesized that the degree of complement activation reflects severity of HF
following acute myocardial infarction. METHODS AND RESULTS: The LEAF trial
(LEvosimendan in Acute heart Failure following myocardial infarction) evaluating
61 patients developing HF within 48 h after percutaneous coronary
intervention-treated ST-elevation myocardial infarction herein underwent a post
hoc analysis. Blood samples were drawn from inclusion to Day 5 and at 42 day
follow-up, and biomarkers were measured with enzyme immunoassays. Regional
myocardial contractility was measured by echocardiography as wall motion score
index (WMSI). The cardiogenic shock group (n = 9) was compared with the non-shock
group (n = 52). Controls (n = 44) were age-matched and sex-matched healthy
individuals. C4bc, C3bc, C3bBbP, and sC5b-9 were elevated in patients at
inclusion compared with controls (P < 0.01). The shock group had higher levels
compared with the non-shock group for all activation products except C3bBbP
(P < 0.05). At Day 42, all products were higher in the shock group (P < 0.05). In
the shock group, sC5b-9 correlated significantly with WMSI at baseline (r = 0.68;
P = 0.045) and at Day 42 (r = 0.84; P = 0.036). Peak sC5b-9 level correlated
strongly with WMSI at Day 42 (r = 0.98; P = 0.005). Circulating endothelial cell
activation markers sICAM-1 and sVCAM-1 were higher in the shock group during the
acute phase (P < 0.01), and their peak levels correlated with sC5b-9 peak level
in the whole HF population (r = 0.32; P = 0.014 and r = 0.30; P = 0.022,
respectively). CONCLUSIONS: Complement activation discriminated cardiogenic shock
from non-shock in acute ST-elevation myocardial infarction complicated by HF and
correlated with regional contractility and endothelial cell activation,
suggesting a pathogenic role of complement in this condition.