Neuropeptide‐Y Levels in ST‐Segment–Elevation Myocardial Infarction: Relationship With Coronary Microvascular Function, Heart Failure, and Mortality
Background The sympathetic cotransmitter, neuropeptide Y (NPY), is released into the coronary sinus during ST‐segment–elevation myocardial infarction and can constrict the coronary microvasculature. We sought to establish whether peripheral venous (PV) NPY levels, which are easy to obtain and measur...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-07-01
|
| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.121.024850 |
| _version_ | 1811167068744056832 |
|---|---|
| author | Thomas Gibbs Nidi Tapoulal Mayooran Shanmuganathan Matthew K. Burrage Alessandra Borlotti Adrian P. Banning Robin P. Choudhury Stefan Neubauer Rajesh K. Kharbanda Vanessa M. Ferreira Keith M. Channon Neil Herring |
| author_facet | Thomas Gibbs Nidi Tapoulal Mayooran Shanmuganathan Matthew K. Burrage Alessandra Borlotti Adrian P. Banning Robin P. Choudhury Stefan Neubauer Rajesh K. Kharbanda Vanessa M. Ferreira Keith M. Channon Neil Herring |
| author_sort | Thomas Gibbs |
| collection | DOAJ |
| description | Background The sympathetic cotransmitter, neuropeptide Y (NPY), is released into the coronary sinus during ST‐segment–elevation myocardial infarction and can constrict the coronary microvasculature. We sought to establish whether peripheral venous (PV) NPY levels, which are easy to obtain and measure, are associated with microvascular obstruction, myocardial recovery, and prognosis. Methods and Results NPY levels were measured immediately after primary percutaneous coronary intervention and compared with angiographic and cardiovascular magnetic resonance indexes of microvascular function. Patients were prospectively followed up for 6.4 (interquartile range, 4.1–8.0) years. PV (n=163) and coronary sinus (n=68) NPY levels were significantly correlated (r=0.92; P<0.001) and associated with multiple coronary and imaging parameters of microvascular function and infarct size (such as coronary flow reserve, acute myocardial edema, left ventricular ejection fraction, and late gadolinium enhancement 6 months later). We therefore assessed the prognostic value of PV NPY during follow‐up, where 34 patients (20.7%) developed heart failure or died. Kaplan‐Meier survival analysis demonstrated that high PV NPY levels (>21.4 pg/mL by binary recursive partitioning) were associated with increased incidence of heart failure and mortality (hazard ratio, 3.49 [95% CI, 1.65–7.4]; P<0.001). This relationship was maintained after adjustment for age, cardiovascular risk factors, and previous myocardial infarction. Conclusions Both PV and coronary sinus NPY levels correlate with microvascular function and infarct size after ST‐segment–elevation myocardial infarction. PV NPY levels are associated with the subsequent development of heart failure or mortality and may therefore be a useful prognostic marker. Further research is required to validate these findings. |
| first_indexed | 2024-04-10T16:02:59Z |
| format | Article |
| id | doaj.art-ca748537995445bcaff4409e64f9c293 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-10T16:02:59Z |
| publishDate | 2022-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-ca748537995445bcaff4409e64f9c2932023-02-10T09:15:42ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802022-07-01111310.1161/JAHA.121.024850Neuropeptide‐Y Levels in ST‐Segment–Elevation Myocardial Infarction: Relationship With Coronary Microvascular Function, Heart Failure, and MortalityThomas Gibbs0Nidi Tapoulal1Mayooran Shanmuganathan2Matthew K. Burrage3Alessandra Borlotti4Adrian P. Banning5Robin P. Choudhury6Stefan Neubauer7Rajesh K. Kharbanda8Vanessa M. Ferreira9Keith M. Channon10Neil Herring11Department of Physiology, Anatomy and Genetics, Burdon Sanderson Cardiac Science Centre University of Oxford United KingdomDepartment of Physiology, Anatomy and Genetics, Burdon Sanderson Cardiac Science Centre University of Oxford United KingdomDivision of Cardiovascular Medicine, Radcliffe Department of Medicine, British Heart Foundation Centre of Research Excellence University of Oxford United KingdomDivision of Cardiovascular Medicine, Radcliffe Department of Medicine, British Heart Foundation Centre of Research Excellence University of Oxford United KingdomDivision of Cardiovascular Medicine, Radcliffe Department of Medicine, British Heart Foundation Centre of Research Excellence University of Oxford United KingdomNational Institute for Health Research Oxford Biomedical Research Centre Oxford University Hospitals NHS Foundation Trust Oxford United KingdomDivision of Cardiovascular Medicine, Radcliffe Department of Medicine, British Heart Foundation Centre of Research Excellence University of Oxford United KingdomDivision of Cardiovascular Medicine, Radcliffe Department of Medicine, British Heart Foundation Centre of Research Excellence University of Oxford United KingdomDivision of Cardiovascular Medicine, Radcliffe Department of Medicine, British Heart Foundation Centre of Research Excellence University of Oxford United KingdomDivision of Cardiovascular Medicine, Radcliffe Department of Medicine, British Heart Foundation Centre of Research Excellence University of Oxford United KingdomDivision of Cardiovascular Medicine, Radcliffe Department of Medicine, British Heart Foundation Centre of Research Excellence University of Oxford United KingdomDepartment of Physiology, Anatomy and Genetics, Burdon Sanderson Cardiac Science Centre University of Oxford United KingdomBackground The sympathetic cotransmitter, neuropeptide Y (NPY), is released into the coronary sinus during ST‐segment–elevation myocardial infarction and can constrict the coronary microvasculature. We sought to establish whether peripheral venous (PV) NPY levels, which are easy to obtain and measure, are associated with microvascular obstruction, myocardial recovery, and prognosis. Methods and Results NPY levels were measured immediately after primary percutaneous coronary intervention and compared with angiographic and cardiovascular magnetic resonance indexes of microvascular function. Patients were prospectively followed up for 6.4 (interquartile range, 4.1–8.0) years. PV (n=163) and coronary sinus (n=68) NPY levels were significantly correlated (r=0.92; P<0.001) and associated with multiple coronary and imaging parameters of microvascular function and infarct size (such as coronary flow reserve, acute myocardial edema, left ventricular ejection fraction, and late gadolinium enhancement 6 months later). We therefore assessed the prognostic value of PV NPY during follow‐up, where 34 patients (20.7%) developed heart failure or died. Kaplan‐Meier survival analysis demonstrated that high PV NPY levels (>21.4 pg/mL by binary recursive partitioning) were associated with increased incidence of heart failure and mortality (hazard ratio, 3.49 [95% CI, 1.65–7.4]; P<0.001). This relationship was maintained after adjustment for age, cardiovascular risk factors, and previous myocardial infarction. Conclusions Both PV and coronary sinus NPY levels correlate with microvascular function and infarct size after ST‐segment–elevation myocardial infarction. PV NPY levels are associated with the subsequent development of heart failure or mortality and may therefore be a useful prognostic marker. Further research is required to validate these findings.https://www.ahajournals.org/doi/10.1161/JAHA.121.024850biomarkercardiovascular magnetic resonance imagingmicrovasculaturepercutaneous coronary interventionprognosissympathetic cotransmitter |
| spellingShingle | Thomas Gibbs Nidi Tapoulal Mayooran Shanmuganathan Matthew K. Burrage Alessandra Borlotti Adrian P. Banning Robin P. Choudhury Stefan Neubauer Rajesh K. Kharbanda Vanessa M. Ferreira Keith M. Channon Neil Herring Neuropeptide‐Y Levels in ST‐Segment–Elevation Myocardial Infarction: Relationship With Coronary Microvascular Function, Heart Failure, and Mortality Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease biomarker cardiovascular magnetic resonance imaging microvasculature percutaneous coronary intervention prognosis sympathetic cotransmitter |
| title | Neuropeptide‐Y Levels in ST‐Segment–Elevation Myocardial Infarction: Relationship With Coronary Microvascular Function, Heart Failure, and Mortality |
| title_full | Neuropeptide‐Y Levels in ST‐Segment–Elevation Myocardial Infarction: Relationship With Coronary Microvascular Function, Heart Failure, and Mortality |
| title_fullStr | Neuropeptide‐Y Levels in ST‐Segment–Elevation Myocardial Infarction: Relationship With Coronary Microvascular Function, Heart Failure, and Mortality |
| title_full_unstemmed | Neuropeptide‐Y Levels in ST‐Segment–Elevation Myocardial Infarction: Relationship With Coronary Microvascular Function, Heart Failure, and Mortality |
| title_short | Neuropeptide‐Y Levels in ST‐Segment–Elevation Myocardial Infarction: Relationship With Coronary Microvascular Function, Heart Failure, and Mortality |
| title_sort | neuropeptide y levels in st segment elevation myocardial infarction relationship with coronary microvascular function heart failure and mortality |
| topic | biomarker cardiovascular magnetic resonance imaging microvasculature percutaneous coronary intervention prognosis sympathetic cotransmitter |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.121.024850 |
| work_keys_str_mv | AT thomasgibbs neuropeptideylevelsinstsegmentelevationmyocardialinfarctionrelationshipwithcoronarymicrovascularfunctionheartfailureandmortality AT niditapoulal neuropeptideylevelsinstsegmentelevationmyocardialinfarctionrelationshipwithcoronarymicrovascularfunctionheartfailureandmortality AT mayooranshanmuganathan neuropeptideylevelsinstsegmentelevationmyocardialinfarctionrelationshipwithcoronarymicrovascularfunctionheartfailureandmortality AT matthewkburrage neuropeptideylevelsinstsegmentelevationmyocardialinfarctionrelationshipwithcoronarymicrovascularfunctionheartfailureandmortality AT alessandraborlotti neuropeptideylevelsinstsegmentelevationmyocardialinfarctionrelationshipwithcoronarymicrovascularfunctionheartfailureandmortality AT adrianpbanning neuropeptideylevelsinstsegmentelevationmyocardialinfarctionrelationshipwithcoronarymicrovascularfunctionheartfailureandmortality AT robinpchoudhury neuropeptideylevelsinstsegmentelevationmyocardialinfarctionrelationshipwithcoronarymicrovascularfunctionheartfailureandmortality AT stefanneubauer neuropeptideylevelsinstsegmentelevationmyocardialinfarctionrelationshipwithcoronarymicrovascularfunctionheartfailureandmortality AT rajeshkkharbanda neuropeptideylevelsinstsegmentelevationmyocardialinfarctionrelationshipwithcoronarymicrovascularfunctionheartfailureandmortality AT vanessamferreira neuropeptideylevelsinstsegmentelevationmyocardialinfarctionrelationshipwithcoronarymicrovascularfunctionheartfailureandmortality AT keithmchannon neuropeptideylevelsinstsegmentelevationmyocardialinfarctionrelationshipwithcoronarymicrovascularfunctionheartfailureandmortality AT neilherring neuropeptideylevelsinstsegmentelevationmyocardialinfarctionrelationshipwithcoronarymicrovascularfunctionheartfailureandmortality |