Influence of Primary Coronary Intervention on Myocardial Collagen Metabolism and Left Ventricle Remodeling Predicted by Collagen Metabolism Markers

Abstract

SUMMARYThe aims of the present study were to analyze cardiac collagen metabolism changes in vivo during acute and nonacute phases of ST elevation myocardial infarction (STEMI) in patients who were treated with primary coronary intervention (PCI) only, and to determine the predictive significance of collagen I and III synthesis markers (PICP, PIIINP) as well as the collagen I degradation marker (ICTP) on left ventricular function and volume changes after STEMI. Serum levels of the carboxy-terminal propeptide of type I procollagen (PICP) and amino-terminal propeptide of type III procollagen (PIIINP) assessed on the 30th day and the carboxyterminal telopeptide located at the C end of collagen type I (ICTP) assessed on the 7th day after STEMI were significantly higher (P = 0.01, P = 0.019, P = 0.04, respectively) in the PCI unsuccessful group than in the PCI successful group. These findings support the theory that early and successful PCI not only limits the amount of muscle necrosis but also protects cardiac collagen from ischemia-related injury. PICP and PIIINP levels assessed on the fourth day after acute STEMI enables us to predict the development of left ventricular function (EF) and end-diastolic volume changes over the course of 6 months, irrespective of the initial EF or revascularization success.

Extracellular Matrix Turnover Biomarkers Predict Long-Term Left Ventricular Remodeling After Myocardial Infarction

“…6,24 Several studies have attempted to develop risk scores in order to predict cardiovascular outcomes and LV remodeling in patients with MI.…”

Effect of coronary revascularization on serum collagen biomarkers and left ventricular remodeling in patients with acute myocardial infarction

“…In contrast to previous studies where late coronary revascularization was often compared with drug therapy, [9][10][11] we investigated the effects of late and early coronary revascularization on serum collagen biomarkers and LV remodeling. No significant difference in LV end-systolic or end-diastolic volumes between the early and late coronary revascularization groups was evident 6 months after their MI.…”

“…10 In patients successfully treated with coronary revascularization soon after their MI, the levels of serum PICP and PIIINP are lower than in those without successful revascularization, suggesting that early coronary revascularization alleviates the synthesis of cardiac collagen induced by ischemic injury. 11 Little information is available about the impact of late coronary revascularization on the synthesis of myocardial collagen or serum collagen biomarkers. This study sought to investigate the effects of late coronary revascularization on serum collagen biomarkers and LV remodeling after an AMI.…”

Predictive value of serum collagen biomakers on the outcome of acute myocardial infarction treated with percutaneous coronary intervention

“…Several earlier clinical observations in a small number of patients have found that coronary revascularization with PCI or thrombolytic therapy within the first 12 h of symptom onset diminished MI-induced PICP or PIIINP elevation 8,9 . Although the reduction in PICP or PIIINP may represent less ventricular remodeling or dysfunction, the predictive value of post-PCI PICP and PIIINP on left ventricular function remains controversial 8,9 .…”

“…Although the reduction in PICP or PIIINP may represent less ventricular remodeling or dysfunction, the predictive value of post-PCI PICP and PIIINP on left ventricular function remains controversial 8,9 . In the present study, we investigated the relations between post-PCI levels of serum PICP and PIIINP and the clinical outcome in patients with STEMI.…”