Association Between Haptoglobin Phenotype and Microvascular Obstruction in Patients With ST-Segment Elevation Myocardial Infarction: A Cardiac Magnetic Resonance Study

Research output: Contribution to journalArticle

Abstract

Objectives: This study aimed to evaluate the correlation between different haptoglobin (Hp) phenotypes and myocardial infarction characteristics as detected by cardiac magnetic resonance (CMR) in consecutive patients after ST-segment elevation myocardial infarction (STEMI). Background: Hp is a plasma protein that prevents iron-mediated oxidative tissue damage. CMR has emerged as the gold standard technique to detect left ventricular ejection fraction (LVEF), extent of scar with late gadolinium enhancement (LGE) technique, microvascular obstruction (MVO), and myocardial hemorrhage (MH) in patients with STEMI treated by primary percutaneous coronary intervention (pPCI). Methods: One hundred forty-five consecutive STEMI patients (mean age 62.2 ± 10.3 years; 78% men) were prospectively enrolled and underwent Hp phenotyping and CMR assessment within 1 week after STEMI. Results: CMR showed an area at risk (AAR) involving 26.6 ± 19.1% of left ventricular (LV) mass with a late LGE extent of 15.2 ± 13.1% of LV mass. MVO and MH occurred in 38 (26%) and 12 (8%) patients, respectively. Hp phenotypes 1-1, 2-1, 2-2 were observed in 15 (10%), 62 (43%), and 68 (47%), respectively. Multivariable analysis demonstrated that body mass index, Hp2-2, diabetes, and peak troponin I were independent predictors of MVO with Hp2-2 associated with the highest odds ratio (OR) (OR: 5.5 [95% confidence interval [CI]: 2.1 to 14.3; p < 0.001]). Hp2-2 significantly predicted both the presence (area under the curve [AUC]: 0.63 [95% CI: 0.53 to 0.72; p = 0.008]) and extent of MVO (AUC: 0.63 [95% CI: 0.54 to 0.72; p = 0.007]). Conclusions: Hp phenotype is an independent predictor of MVO. Therefore, Hp phenotyping could be used for risk stratification and may be useful in assessing new therapies to reduce myocardial reperfusion injury in patients with STEMI.

Original languageEnglish
JournalJACC: Cardiovascular Imaging
DOIs
Publication statusAccepted/In press - Jan 1 2018

Fingerprint

Haptoglobins
Magnetic Resonance Spectroscopy
Phenotype
Gadolinium
Confidence Intervals
Area Under Curve
Odds Ratio
Hemorrhage
Myocardial Reperfusion Injury
Troponin I
Percutaneous Coronary Intervention
Stroke Volume
Cicatrix
ST Elevation Myocardial Infarction
Blood Proteins
Body Mass Index
Iron
Myocardial Infarction

Keywords

  • cardiac magnetic resonance
  • haptoglobin
  • microvascular obstruction
  • myocardial infarction

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

@article{b567731abfa44f60adf60e2eb333e1a4,
title = "Association Between Haptoglobin Phenotype and Microvascular Obstruction in Patients With ST-Segment Elevation Myocardial Infarction: A Cardiac Magnetic Resonance Study",
abstract = "Objectives: This study aimed to evaluate the correlation between different haptoglobin (Hp) phenotypes and myocardial infarction characteristics as detected by cardiac magnetic resonance (CMR) in consecutive patients after ST-segment elevation myocardial infarction (STEMI). Background: Hp is a plasma protein that prevents iron-mediated oxidative tissue damage. CMR has emerged as the gold standard technique to detect left ventricular ejection fraction (LVEF), extent of scar with late gadolinium enhancement (LGE) technique, microvascular obstruction (MVO), and myocardial hemorrhage (MH) in patients with STEMI treated by primary percutaneous coronary intervention (pPCI). Methods: One hundred forty-five consecutive STEMI patients (mean age 62.2 ± 10.3 years; 78{\%} men) were prospectively enrolled and underwent Hp phenotyping and CMR assessment within 1 week after STEMI. Results: CMR showed an area at risk (AAR) involving 26.6 ± 19.1{\%} of left ventricular (LV) mass with a late LGE extent of 15.2 ± 13.1{\%} of LV mass. MVO and MH occurred in 38 (26{\%}) and 12 (8{\%}) patients, respectively. Hp phenotypes 1-1, 2-1, 2-2 were observed in 15 (10{\%}), 62 (43{\%}), and 68 (47{\%}), respectively. Multivariable analysis demonstrated that body mass index, Hp2-2, diabetes, and peak troponin I were independent predictors of MVO with Hp2-2 associated with the highest odds ratio (OR) (OR: 5.5 [95{\%} confidence interval [CI]: 2.1 to 14.3; p < 0.001]). Hp2-2 significantly predicted both the presence (area under the curve [AUC]: 0.63 [95{\%} CI: 0.53 to 0.72; p = 0.008]) and extent of MVO (AUC: 0.63 [95{\%} CI: 0.54 to 0.72; p = 0.007]). Conclusions: Hp phenotype is an independent predictor of MVO. Therefore, Hp phenotyping could be used for risk stratification and may be useful in assessing new therapies to reduce myocardial reperfusion injury in patients with STEMI.",
keywords = "cardiac magnetic resonance, haptoglobin, microvascular obstruction, myocardial infarction",
author = "Gianluca Pontone and Daniele Andreini and Guaricci, {Andrea I.} and Marco Guglielmo and Andrea Baggiano and Giuseppe Muscogiuri and Laura Fusini and Fabio Fazzari and Claudio Berzovini and Annalisa Pasquini and Saima Mushtaq and Edoardo Conte and Nicola Cosentino and Rabbat, {Mark G.} and Giancarlo Marenzi and Bartorelli, {Antonio L.} and Mauro Pepi and Elena Tremoli and Cristina Banfi",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.jcmg.2018.03.004",
language = "English",
journal = "JACC: Cardiovascular Imaging",
issn = "1936-878X",
publisher = "NLM (Medline)",

}

TY - JOUR

T1 - Association Between Haptoglobin Phenotype and Microvascular Obstruction in Patients With ST-Segment Elevation Myocardial Infarction

T2 - A Cardiac Magnetic Resonance Study

AU - Pontone, Gianluca

AU - Andreini, Daniele

AU - Guaricci, Andrea I.

AU - Guglielmo, Marco

AU - Baggiano, Andrea

AU - Muscogiuri, Giuseppe

AU - Fusini, Laura

AU - Fazzari, Fabio

AU - Berzovini, Claudio

AU - Pasquini, Annalisa

AU - Mushtaq, Saima

AU - Conte, Edoardo

AU - Cosentino, Nicola

AU - Rabbat, Mark G.

AU - Marenzi, Giancarlo

AU - Bartorelli, Antonio L.

AU - Pepi, Mauro

AU - Tremoli, Elena

AU - Banfi, Cristina

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objectives: This study aimed to evaluate the correlation between different haptoglobin (Hp) phenotypes and myocardial infarction characteristics as detected by cardiac magnetic resonance (CMR) in consecutive patients after ST-segment elevation myocardial infarction (STEMI). Background: Hp is a plasma protein that prevents iron-mediated oxidative tissue damage. CMR has emerged as the gold standard technique to detect left ventricular ejection fraction (LVEF), extent of scar with late gadolinium enhancement (LGE) technique, microvascular obstruction (MVO), and myocardial hemorrhage (MH) in patients with STEMI treated by primary percutaneous coronary intervention (pPCI). Methods: One hundred forty-five consecutive STEMI patients (mean age 62.2 ± 10.3 years; 78% men) were prospectively enrolled and underwent Hp phenotyping and CMR assessment within 1 week after STEMI. Results: CMR showed an area at risk (AAR) involving 26.6 ± 19.1% of left ventricular (LV) mass with a late LGE extent of 15.2 ± 13.1% of LV mass. MVO and MH occurred in 38 (26%) and 12 (8%) patients, respectively. Hp phenotypes 1-1, 2-1, 2-2 were observed in 15 (10%), 62 (43%), and 68 (47%), respectively. Multivariable analysis demonstrated that body mass index, Hp2-2, diabetes, and peak troponin I were independent predictors of MVO with Hp2-2 associated with the highest odds ratio (OR) (OR: 5.5 [95% confidence interval [CI]: 2.1 to 14.3; p < 0.001]). Hp2-2 significantly predicted both the presence (area under the curve [AUC]: 0.63 [95% CI: 0.53 to 0.72; p = 0.008]) and extent of MVO (AUC: 0.63 [95% CI: 0.54 to 0.72; p = 0.007]). Conclusions: Hp phenotype is an independent predictor of MVO. Therefore, Hp phenotyping could be used for risk stratification and may be useful in assessing new therapies to reduce myocardial reperfusion injury in patients with STEMI.

AB - Objectives: This study aimed to evaluate the correlation between different haptoglobin (Hp) phenotypes and myocardial infarction characteristics as detected by cardiac magnetic resonance (CMR) in consecutive patients after ST-segment elevation myocardial infarction (STEMI). Background: Hp is a plasma protein that prevents iron-mediated oxidative tissue damage. CMR has emerged as the gold standard technique to detect left ventricular ejection fraction (LVEF), extent of scar with late gadolinium enhancement (LGE) technique, microvascular obstruction (MVO), and myocardial hemorrhage (MH) in patients with STEMI treated by primary percutaneous coronary intervention (pPCI). Methods: One hundred forty-five consecutive STEMI patients (mean age 62.2 ± 10.3 years; 78% men) were prospectively enrolled and underwent Hp phenotyping and CMR assessment within 1 week after STEMI. Results: CMR showed an area at risk (AAR) involving 26.6 ± 19.1% of left ventricular (LV) mass with a late LGE extent of 15.2 ± 13.1% of LV mass. MVO and MH occurred in 38 (26%) and 12 (8%) patients, respectively. Hp phenotypes 1-1, 2-1, 2-2 were observed in 15 (10%), 62 (43%), and 68 (47%), respectively. Multivariable analysis demonstrated that body mass index, Hp2-2, diabetes, and peak troponin I were independent predictors of MVO with Hp2-2 associated with the highest odds ratio (OR) (OR: 5.5 [95% confidence interval [CI]: 2.1 to 14.3; p < 0.001]). Hp2-2 significantly predicted both the presence (area under the curve [AUC]: 0.63 [95% CI: 0.53 to 0.72; p = 0.008]) and extent of MVO (AUC: 0.63 [95% CI: 0.54 to 0.72; p = 0.007]). Conclusions: Hp phenotype is an independent predictor of MVO. Therefore, Hp phenotyping could be used for risk stratification and may be useful in assessing new therapies to reduce myocardial reperfusion injury in patients with STEMI.

KW - cardiac magnetic resonance

KW - haptoglobin

KW - microvascular obstruction

KW - myocardial infarction

UR - http://www.scopus.com/inward/record.url?scp=85045344905&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85045344905&partnerID=8YFLogxK

U2 - 10.1016/j.jcmg.2018.03.004

DO - 10.1016/j.jcmg.2018.03.004

M3 - Article

AN - SCOPUS:85045344905

JO - JACC: Cardiovascular Imaging

JF - JACC: Cardiovascular Imaging

SN - 1936-878X

ER -