Peptide YY (PYY) Is Associated with Cardiovascular Risk in Patients with Acute Myocardial Infarction

Abstract

Aims: Recent studies have found circulating concentrations of the gastrointestinal hormone GLP-1 to be an excellent predictor of cardiovascular risk in patients with myocardial infarction. This illustrates a yet not appreciated crosstalk between the gastrointestinal and cardiovascular systems, which requires further investigation. The gut-derived hormone Peptide YY (PYY) is secreted from the same intestinal L-cells as GLP-1. Relevance of PYY in the context of cardiovascular disease has not been explored. In this study, we aimed to investigate PYY serum concentrations in patients with acute myocardial infarction and to evaluate their association with cardiovascular events. Material and Methods: PYY levels were assessed in 834 patients presenting with acute myocardial infarction (553 Non-ST-Elevation Myocardial Infarction (NSTEMI) and 281 ST-Elevation Myocardial Infarction (STEMI)) at the time of hospital admission. The composite outcomes of first occurrence of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke (3-P-MACE), and all-cause mortality were assessed with a median follow-up of 338 days. Results: PYY levels were significantly associated with age and cardiovascular risk factors, including hypertension, diabetes, and kidney function in addition to biomarkers of heart failure (NT-pro BNP) and inflammation (hs-CRP). Further, PYY was significantly associated with 3-P-MACE (HR: 1.7; 95% CI: 1–2.97; p = 0.0495) and all-cause mortality (HR: 2.69; 95% CI: 1.61–4.47; p = 0.0001) by univariable Cox regression analyses, which was however lost after adjusting for multiple confounders. Conclusions: PYY levels are associated with parameters of cardiovascular risk as well as cardiovascular events and mortality in patients presenting with acute myocardial infarction. However, this significant association is lost after adjustment for further confounders.

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“…A positive correlation of the PYY level with hs-CRP has also been demonstrated, indicating the inflammatory regulation of the secretion of this neuropeptide. In addition, a correlation with the PYY level has been demonstrated for cardiovascular risk factors (diabetes, hypertension, and hypercholesterolemia) and cardiovascular events [ 38 ]. Our own study showed a higher median level of PYY in HIV-infected men before cART compared to after cART ( p = 0.04) and a lower level of PYY than in the control group ( p = 0.02).…”

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“…PYY levels appear to be affected by acute exercise, macronutrient composition, adiposity, race, and the composition of fatty acids in dietary fat ( 54 ). Moreover, PYY levels were significantly associated with age and cardiovascular risk factors, including hypertension, diabetes, and kidney function, in addition to biomarkers of heart failure and inflammation in patients with acute myocardial infarction ( 55 ). However, PYY was negatively correlated with leptin.…”

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“…PYY deficiency altered the composition of the bacteria phylum in the gut in high-fat diet conditions and caused alterations in the expression of tight junction proteins [ 44 ]. Regarding the cardiac system, PYY was associated with cardiovascular risk factors and major acute cardiovascular events as well as cardiac mortality during follow-up in patients presenting with acute coronary syndromes, although the association was lost after adjusting for multiple confounders [ 45 ].…”