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Bochaton T, Lassus J, Paccalet A, Derimay F, Rioufol G, Prieur C, Bonnefoy-Cudraz E, Crola Da Silva C, Bernelin H, Amaz C, Espanet S, de Bourguignon C, Dufay N, Cartier R, Croisille P, Ovize M, Mewton N. Association of myocardial hemorrhage and persistent microvascular obstruction with circulating inflammatory biomarkers in STEMI patients. PLoS One 2021; 16:e0245684. [PMID: 33507957 PMCID: PMC7842962 DOI: 10.1371/journal.pone.0245684] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 01/01/2021] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Myocardial hemorrhage (IMH) and persistent microvascular obstruction (MVO) are associated with impaired myocardial recovery and adverse clinical outcomes in STEMI patients. However, their relationship with circulating inflammatory biomarkers is unclear in human patients. METHODS AND RESULTS Twenty consecutive patients referred for primary percutaneous coronary intervention of first STEMI were included in a prospective study. Blood sampling was performed at admission, 4, 12, 24, 48 hours, 7 and 30 days after reperfusion for inflammatory biomarker (C reactive protein, fibrinogen, interleukin-6 (IL-6) and neutrophils count) assessment. At seven days, cardiovascular magnetic resonance (CMR) was performed for infarct size, MVO and IMH assessment. Median infarct size was 24.6% Interquartile range (IQR) [12.0-43.5] of LV mass and edema was 13.2% IQR [7.7-36.1] of LV mass. IL-6 reached a peak at H24 (5.6 pg/mL interquartile range (IQR) [2.5-17.5]), CRP at H48 (11.7 mg/L IQR [7.1-69.2]), fibrinogen one week after admission (4.4 g/L IQR [3.8-6.7]) and neutrophils at H12 (9.0 G/L IQR [6.5-12.7]). MVO was present in 11 patients (55% of the study population) and hemorrhage in 7 patients (35%). Patients with IMH had significantly higher IL-6, CRP, fibrinogen, and neutrophils levels compared to patients without IMH. Patients with persistent MVO had significantly higher CRP, fibrinogen and neutrophils level compared to patients without MVO, but identical IL-6 kinetics. CONCLUSION In human patients with acute myocardial infarction, intramyocardial hemorrhage appears to have a stronger relationship with inflammatory biomarker release compared to persistent MVO. Attenuating myocardial hemorrhage may be a novel target in future adjunctive STEMI treatments.
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Affiliation(s)
- Thomas Bochaton
- INSERM U1060, CarMeN Laboratory, Université de Lyon, Groupement Hospitalier Est, Bron, France
- Unité de Soins Intensifs Cardiologiques, Hôpital Louis Pradel et Université Claude Bernard, Hospices Civils de Lyon, Bron, France
- * E-mail:
| | - Jules Lassus
- Centre Hospitalier Universitaire de Martinique, Université des Antilles, Fort de France, France
| | - Alexandre Paccalet
- INSERM U1060, CarMeN Laboratory, Université de Lyon, Groupement Hospitalier Est, Bron, France
| | - François Derimay
- Department of Interventional Cardiology, Cardiovascular Hospital and Claude-Bernard University, Bron, France
| | - Gilles Rioufol
- Department of Interventional Cardiology, Cardiovascular Hospital and Claude-Bernard University, Bron, France
| | - Cyril Prieur
- Unité de Soins Intensifs Cardiologiques, Hôpital Louis Pradel et Université Claude Bernard, Hospices Civils de Lyon, Bron, France
| | - Eric Bonnefoy-Cudraz
- Unité de Soins Intensifs Cardiologiques, Hôpital Louis Pradel et Université Claude Bernard, Hospices Civils de Lyon, Bron, France
| | - Claire Crola Da Silva
- INSERM U1060, CarMeN Laboratory, Université de Lyon, Groupement Hospitalier Est, Bron, France
| | - Hugo Bernelin
- Unité de Soins Intensifs Cardiologiques, Hôpital Louis Pradel et Université Claude Bernard, Hospices Civils de Lyon, Bron, France
| | - Camille Amaz
- Centre d’investigation Clinique de Lyon, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Sylvie Espanet
- Centre d’investigation Clinique de Lyon, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Charles de Bourguignon
- Centre d’investigation Clinique de Lyon, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Nathalie Dufay
- NeuroBioTec, Groupement Hospitalier Est, Hôpital Neurologique Pierre Wertheimer, Bron, France
| | - Régine Cartier
- Centre de biologie Est, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
| | - Pierre Croisille
- Université de Lyon, Université Jean-Monnet Saint-Etienne, INSA, Centre National de la Recherche Scientifique, Unité Mixte de Recherche, Creatis, Saint-Etienne, France
| | - Michel Ovize
- INSERM U1060, CarMeN Laboratory, Université de Lyon, Groupement Hospitalier Est, Bron, France
- Centre d’investigation Clinique de Lyon, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
- Service d’explorations Fonctionnelles Cardiovasculaires, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Nathan Mewton
- INSERM U1060, CarMeN Laboratory, Université de Lyon, Groupement Hospitalier Est, Bron, France
- Centre d’investigation Clinique de Lyon, Hôpital Louis Pradel, Hospices Civils de Lyon, Bron, France
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