Relationship of plasma neuropeptide Y with angiographic, electrocardiographic and coronary physiology indices of reperfusion during ST elevation myocardial infarction
<p><strong>Objectives</strong> The co-transmitter neuropeptide Y (NPY) is released during high levels of sympathetic stimulation and is a potent vasoconstrictor. We defined the release profile of plasma NPY during acute ST elevation myocardial infarction, and tested the hypothesis...
| Main Authors: | , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
BMJ Publishing Group
2013
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| _version_ | 1826305652473987072 |
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| author | Cuculi, F Herring, N De Caterina, A Banning, A Prendergast, B Forfar, J Choudhury, R Channon, K Kharbanda, R |
| author_facet | Cuculi, F Herring, N De Caterina, A Banning, A Prendergast, B Forfar, J Choudhury, R Channon, K Kharbanda, R |
| author_sort | Cuculi, F |
| collection | OXFORD |
| description | <p><strong>Objectives</strong> The co-transmitter neuropeptide Y (NPY) is released during high levels of sympathetic stimulation and is a potent vasoconstrictor. We defined the release profile of plasma NPY during acute ST elevation myocardial infarction, and tested the hypothesis that levels correlate with reperfusion measures after treatment with primary percutaneous coronary intervention (PPCI).</p>
<p><strong>Design</strong> Prospective observational study.</p>
<p><strong>Setting</strong> University hospital heart centre.</p>
<p><strong>Patients</strong> 64 patients (62.6±11.7 years-old, 73% male) presenting throughout the 24-h cycle of clinical activity with ST elevation myocardial infarction.</p>
<p><strong>Interventions</strong> PPCI.</p>
<p><strong>Main outcome measures</strong> NPY was measured (ELISA) in peripheral blood taken before and immediately after PPCI and at 6, 24 and 48 h post-PPCI. Reperfusion was assessed by angiographic criteria, ST segment resolution, invasive measurement of coronary flow reserve and the index of microcirculatory resistance.</p>
<p><strong>Results</strong> Plasma NPY levels were highest before PPCI (17.4 (8.8–42.2) pg/ml, median (IQR)) and dropped significantly post-PPCI (12.4 (6.5–26.7) pg/ml, p<0.0001) and after 6 h (9.0 (2.6–21.5) pg/ml, p=0.008). Patients with admission NPY levels above the median were significantly more hypertensive and tachycardic and were more likely to have diabetes mellitus. Patients with angiographic no-reflow (less than thrombolysis in myocardial infarction 3 flow and myocardial blush grade >2, n=16) or no electrocardiographic ST resolution (<70%, n=30) following PPCI had significantly higher plasma NPY levels. Patients with a coronary flow reserve <1.5 or index of microcirculatory resistance >33 also had significantly higher plasma NPY levels pre-PPCI and post-PPCI.</p>
<p><strong>Conclusions</strong> Plasma NPY levels correlate with indices of reperfusion and coronary microvascular resistance.</p> |
| first_indexed | 2024-03-07T06:36:05Z |
| format | Journal article |
| id | oxford-uuid:f7aba402-e1fa-48a4-8a8d-4b6217f0a122 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T06:36:05Z |
| publishDate | 2013 |
| publisher | BMJ Publishing Group |
| record_format | dspace |
| spelling | oxford-uuid:f7aba402-e1fa-48a4-8a8d-4b6217f0a1222022-03-27T12:44:36ZRelationship of plasma neuropeptide Y with angiographic, electrocardiographic and coronary physiology indices of reperfusion during ST elevation myocardial infarctionJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:f7aba402-e1fa-48a4-8a8d-4b6217f0a122EnglishSymplectic Elements at OxfordBMJ Publishing Group2013Cuculi, FHerring, NDe Caterina, ABanning, APrendergast, BForfar, JChoudhury, RChannon, KKharbanda, R<p><strong>Objectives</strong> The co-transmitter neuropeptide Y (NPY) is released during high levels of sympathetic stimulation and is a potent vasoconstrictor. We defined the release profile of plasma NPY during acute ST elevation myocardial infarction, and tested the hypothesis that levels correlate with reperfusion measures after treatment with primary percutaneous coronary intervention (PPCI).</p> <p><strong>Design</strong> Prospective observational study.</p> <p><strong>Setting</strong> University hospital heart centre.</p> <p><strong>Patients</strong> 64 patients (62.6±11.7 years-old, 73% male) presenting throughout the 24-h cycle of clinical activity with ST elevation myocardial infarction.</p> <p><strong>Interventions</strong> PPCI.</p> <p><strong>Main outcome measures</strong> NPY was measured (ELISA) in peripheral blood taken before and immediately after PPCI and at 6, 24 and 48 h post-PPCI. Reperfusion was assessed by angiographic criteria, ST segment resolution, invasive measurement of coronary flow reserve and the index of microcirculatory resistance.</p> <p><strong>Results</strong> Plasma NPY levels were highest before PPCI (17.4 (8.8–42.2) pg/ml, median (IQR)) and dropped significantly post-PPCI (12.4 (6.5–26.7) pg/ml, p<0.0001) and after 6 h (9.0 (2.6–21.5) pg/ml, p=0.008). Patients with admission NPY levels above the median were significantly more hypertensive and tachycardic and were more likely to have diabetes mellitus. Patients with angiographic no-reflow (less than thrombolysis in myocardial infarction 3 flow and myocardial blush grade >2, n=16) or no electrocardiographic ST resolution (<70%, n=30) following PPCI had significantly higher plasma NPY levels. Patients with a coronary flow reserve <1.5 or index of microcirculatory resistance >33 also had significantly higher plasma NPY levels pre-PPCI and post-PPCI.</p> <p><strong>Conclusions</strong> Plasma NPY levels correlate with indices of reperfusion and coronary microvascular resistance.</p> |
| spellingShingle | Cuculi, F Herring, N De Caterina, A Banning, A Prendergast, B Forfar, J Choudhury, R Channon, K Kharbanda, R Relationship of plasma neuropeptide Y with angiographic, electrocardiographic and coronary physiology indices of reperfusion during ST elevation myocardial infarction |
| title | Relationship of plasma neuropeptide Y with angiographic, electrocardiographic and coronary physiology indices of reperfusion during ST elevation myocardial infarction |
| title_full | Relationship of plasma neuropeptide Y with angiographic, electrocardiographic and coronary physiology indices of reperfusion during ST elevation myocardial infarction |
| title_fullStr | Relationship of plasma neuropeptide Y with angiographic, electrocardiographic and coronary physiology indices of reperfusion during ST elevation myocardial infarction |
| title_full_unstemmed | Relationship of plasma neuropeptide Y with angiographic, electrocardiographic and coronary physiology indices of reperfusion during ST elevation myocardial infarction |
| title_short | Relationship of plasma neuropeptide Y with angiographic, electrocardiographic and coronary physiology indices of reperfusion during ST elevation myocardial infarction |
| title_sort | relationship of plasma neuropeptide y with angiographic electrocardiographic and coronary physiology indices of reperfusion during st elevation myocardial infarction |
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