Abstract
Background
Elastin fragmentation is implicated in plaque vulnerability. We have investigated the prognostic role of plasma desmosine (pDES), an elastin degradation product, in patients presenting with acute myocardial infarction (MI).
Methods
pDES was measured in 236 patients presenting with acute MI using a stable isotope dilution LC-MS/MS method. Patients were followed up for 2 years for all-cause death and future MI. The incremental value of pDES to GRACE score for risk stratification was assessed.
Results
pDES levels were elevated in patients who had death/MI at 2 years compared to those without (median pDES 0.45 vs 0.36 ng/mL, p=0.002)). Univariable analysis showed that pDES was associated with adverse outcome at 6 months, 1 year & at 2 years [HR 4.49-6.13 (95% CI 1.88-15.51) p≤0.001]. After adjustment for age, sex, history of CVD, revascularisation, blood pressure, medications on discharge, Troponin I, and NT-proBNP levels, the HR remained significant [HR 3.58-5.91 (95% CI 1.05-26.00) p≤0.041]. Kaplan-Meier plot showed that patients with higher pDES levels had a lower event-free survival rate than those with lower pDES (p=0.015) (Figure). pDES provided incremental improvement in risk stratification compared to the GRACE score alone [NRI 41.2 (95% CI 12.0-70.4) p=0.006].
Conclusion
In acute MI patients, pDES is a promising prognostic marker of adverse outcomes that is independent and incremental to the GRACE score.
Elastin fragmentation is implicated in plaque vulnerability. We have investigated the prognostic role of plasma desmosine (pDES), an elastin degradation product, in patients presenting with acute myocardial infarction (MI).
Methods
pDES was measured in 236 patients presenting with acute MI using a stable isotope dilution LC-MS/MS method. Patients were followed up for 2 years for all-cause death and future MI. The incremental value of pDES to GRACE score for risk stratification was assessed.
Results
pDES levels were elevated in patients who had death/MI at 2 years compared to those without (median pDES 0.45 vs 0.36 ng/mL, p=0.002)). Univariable analysis showed that pDES was associated with adverse outcome at 6 months, 1 year & at 2 years [HR 4.49-6.13 (95% CI 1.88-15.51) p≤0.001]. After adjustment for age, sex, history of CVD, revascularisation, blood pressure, medications on discharge, Troponin I, and NT-proBNP levels, the HR remained significant [HR 3.58-5.91 (95% CI 1.05-26.00) p≤0.041]. Kaplan-Meier plot showed that patients with higher pDES levels had a lower event-free survival rate than those with lower pDES (p=0.015) (Figure). pDES provided incremental improvement in risk stratification compared to the GRACE score alone [NRI 41.2 (95% CI 12.0-70.4) p=0.006].
Conclusion
In acute MI patients, pDES is a promising prognostic marker of adverse outcomes that is independent and incremental to the GRACE score.
| Original language | English |
|---|---|
| Pages (from-to) | 973 |
| Number of pages | 1 |
| Journal | JACC: Journal of the American College of Cardiology |
| Volume | 79 |
| Issue number | 9_Supplement |
| Publication status | Published - 1 Apr 2022 |
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THE CLINICAL UTILITY OF PLASMA DESMOSINE AS A BIOMARKER OF ATHEROSCLEROSIS AND PLAQUE INSTABILITY
Ali, K. (Author), Choy, A.-M. (Supervisor) & Huang, J. (Supervisor), 2025Student thesis: Doctoral Thesis › Doctor of Medicine
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