Syndecan-1 Predicts Outcome in Patients with ST-Segment Elevation Infarction Independent from Infarct-related Myocardial Injury

Abstract

Syndecan-1 (sdc1) is a surface protein part of the endothelial glycocalyx (eGC). Soluble sdc1 is derived from shedding and indicates damaged eGC. We assessed the predictive value of plasma sdc1 concentrations for future cardiovascular events in acute reperfused ST-segment elevation myocardial infarction (STEMI) patients. A total of 206 patients admitted for STEMI were included in this study (29% female; age 65 ± 12 years) and followed-up for six months. Plasma samples were obtained post-intervention and analyzed for sdc1 by Enzyme-linked Immunosorbent Assay (ELISA). Primary outcome was six-month-mortality. Sdc1 did not correlate with biomarkers such as creatine kinase (CK) (r = 0.11; p = 0.01) or troponin (r = −0.12; p = 0.09), nor with infarct size (r = −0.04; p = 0.67) and myocardial salvage index (r = 0.11; p = 0.17). Sdc-1 was associated with mortality (changes per 100 ng/mL sdc-1 concentration; HR 1.08 95% 1.03–1.12; p = 0.001). An optimal cut-off was calculated at >120 ng/mL. After correction for known risk factors sdc1 >120 ng/mL was independently associated with mortality after 6 months. In our study, sdc1 is independently associated with six-month-mortality after STEMI. Combining clinical evaluation and different biomarkers assessing both infarct-related myocardial injury and systemic stress response might improve the accuracy of predicting clinical prognosis in STEMI patients.

Circulating Levels of the Heparan Sulfate Proteoglycan Syndecan-4 Positively Associate with Blood Pressure in Healthy Premenopausal Women

“…It is well-established that catecholamines regulate blood pressure [34]. In high concentrations, catecholamines can also directly damage the endothelium most likely by enhancing eGC degradation [35][36][37]. For instance, circulating NE and epinephrine were found significantly correlated with plasma SDC1 in patients with ST elevation myocardial infarction, with the highest levels of epinephrine and SDC1 in patients with shock prior to primary percutaneous coronary intervention [36].…”

IL-34 and CSF-1, deciphering similarities and differences at steady state and in diseases

“…CD138 overexpression is beneficial in post‐myocardial infarction in rats since it plays a role in the interaction leukocytes/endothelium 162 . However, elevated soluble CD138 serum level in acute reperfused ST‐segment elevation myocardial infarction patients and patients in cardiogenic shock is associated with increased mortality 163,164 . Thus, these receptors provide new biological roles for IL‐34 and could explain the differences with CSF‐1.…”

The Role of Matrix Proteins in Cardiac Pathology

“…A study of plasma syndecan-1 levels (n = 567) demonstrated a positive correlation with all-cause mortality and rehospitalization for heart failure in patients with a preserved ejection fraction [179]. Elevated syndecan-1 levels are also independently associated with increased mortality after ST-elevation MI [180].…”

“…Syndecan-4 expression in the myocardium is increased in failing hearts (n = 20) compared to non-failing hearts (n = 10). [179,180,182,183] Abbreviations: ACS: acute coronary syndrome; AF: atrial fibrillation; BMI: body mass index; CAD: coronary artery disease; CV: cardiovascular; DCM: dilated cardiomyopathy; EF: ejection fraction; HR: hazard ratio; HF: heart failure; HFpEF: heart failure with preserved ejection fraction; HFrEF: heart failure with reduced ejection fraction; LA: left atrial; LV: left ventricular; LVH: left ventricular hypertrophy; MACE: major adverse cardiac events; MI: myocardial infarction; MMP: matrix metalloproteinase; OPN: osteopontin; PAH: pulmonary arterial hypertension; SLE: systemic lupus erythematosus; SNP: single nucleotide polymorphism; TN-C: tenascin C; TSP: thrombospondin.…”