The prognostic role of vasculoendothelial growth factor A in patients with ST-segment elevation acute myocardial infarction during 6-months follow-up period
The aim – to evaluate the prognostic role of vasculoendothelial growth factor A (VEGF-A) in patients with ST segment elevation acute myocardial infarction (STEMI) after successful revascularization during the 6-month follow-up period. Materials and methods. We studied 135 patients with STEMI, 109...
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TOV Chetverta Khvylia
2020-06-01
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| Series: | Кардіохірургія та інтервенційна кардіологія |
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| Online Access: | http://csic.com.ua/images/pdf/2020/2-2020/prognostic-role-vasculoendothelial-growth-factor-a-in-patients-with-acute-myocardial-infarction.pdf |
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| author | N.P. Kopytsya I.M. Кutya I.V. Rodionova Ya.V. Hilova |
| author_facet | N.P. Kopytsya I.M. Кutya I.V. Rodionova Ya.V. Hilova |
| author_sort | N.P. Kopytsya |
| collection | DOAJ |
| description | The aim – to evaluate the prognostic role of vasculoendothelial growth factor A (VEGF-A) in patients with ST segment elevation acute myocardial infarction (STEMI) after successful revascularization during the 6-month follow-up period.
Materials and methods. We studied 135 patients with STEMI, 109 (80.7 %) men, 26 (19.3 %) women, average age (59.21 ± 8.92) years. The control group consisted of 30 healthy individuals. The blood flow was restored at the level of ТІМІ III in patients included in the study. The level of VEGF-A was determined by enzyme immunoassay. Blood for determining VEGF-A was taken on the 5-7th day of the disease.
Results. The level of VEGF-A in the main group was 247.94 [107.22–486.50] pg/ml. In the control group, the level of VEGF-A was 80.76 [56.20–149.51] pg/ml (p = 0.011). The selected group of patients who reached the combined endpoint included 29 (21.5 %) patients (group 1). The second group consisted of 106 people without cardiovascular events (group 2). LVEF (p = 0.002), E/E' diastolic dysfunction (p = 0.007), creatinine clearance (p = 0.018) were lower in the 1st group. The level of VEGF-A – 217.40 [102.54–473.78] pg/ml was significantly lower in the indicated (1st) group of patients versus 311.45 [204.20–680.86] pg/ml in the second group (p = 0.046). The threshold level of VEGF-A ≤ 255.72 pg/ml (area under the ROC curve 0.630; 95 % confidence interval 0.534–0.719; p = 0.0472) was determined. A biomarker concentration below this level with a sensitivity of 72 % and a specificity of 58 % has a negative prognostic value for 6 months after STEMI. Multivariate regression logistic analysis of predictors of the combined endpoint showed that the level of VEGF-A, LDL-C, and the complicated course of the acute MI period are predictors of the adverse course of the disease (p = 0.005).
Conclusions. In patients who reached the endpoint, a significantly lower concentration of VEGF-A was recorded (p = 0.011). A decrease in the level of VEGF-A < 255.72 pg/ml is a sensitive prognostic marker for the adverse course of the post-infarction period. The prognostic model for the development of adverse events during 6 months follow-up is constructed, with inclusion of the VEGF-A, LDL-C concentration and complications in the acute period of the disease, increases the accuracy of prediction power predominantly because of higher specificity. |
| format | Article |
| id | doaj-art-1336c7e8c37641cb9914093a6d13f433 |
| institution | Kabale University |
| issn | 2305-3127 |
| language | English |
| publishDate | 2020-06-01 |
| publisher | TOV Chetverta Khvylia |
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| series | Кардіохірургія та інтервенційна кардіологія |
| spelling | doaj-art-1336c7e8c37641cb9914093a6d13f4332025-02-02T04:11:11ZengTOV Chetverta KhvyliaКардіохірургія та інтервенційна кардіологія2305-31272020-06-0121827http://doi.org/10.31928/2305-3127-2020.2.1827The prognostic role of vasculoendothelial growth factor A in patients with ST-segment elevation acute myocardial infarction during 6-months follow-up periodN.P. Kopytsya0I.M. Кutya1I.V. Rodionova2Ya.V. Hilova3L.T. Malaya Therapy National Institute of the NAMS of Ukraine, Kharkiv, UkraineL.T. Malaya Therapy National Institute of the NAMS of Ukraine, Kharkiv, UkraineL.T. Malaya Therapy National Institute of the NAMS of Ukraine, Kharkiv, UkraineL.T. Malaya Therapy National Institute of the NAMS of Ukraine, Kharkiv, UkraineThe aim – to evaluate the prognostic role of vasculoendothelial growth factor A (VEGF-A) in patients with ST segment elevation acute myocardial infarction (STEMI) after successful revascularization during the 6-month follow-up period. Materials and methods. We studied 135 patients with STEMI, 109 (80.7 %) men, 26 (19.3 %) women, average age (59.21 ± 8.92) years. The control group consisted of 30 healthy individuals. The blood flow was restored at the level of ТІМІ III in patients included in the study. The level of VEGF-A was determined by enzyme immunoassay. Blood for determining VEGF-A was taken on the 5-7th day of the disease. Results. The level of VEGF-A in the main group was 247.94 [107.22–486.50] pg/ml. In the control group, the level of VEGF-A was 80.76 [56.20–149.51] pg/ml (p = 0.011). The selected group of patients who reached the combined endpoint included 29 (21.5 %) patients (group 1). The second group consisted of 106 people without cardiovascular events (group 2). LVEF (p = 0.002), E/E' diastolic dysfunction (p = 0.007), creatinine clearance (p = 0.018) were lower in the 1st group. The level of VEGF-A – 217.40 [102.54–473.78] pg/ml was significantly lower in the indicated (1st) group of patients versus 311.45 [204.20–680.86] pg/ml in the second group (p = 0.046). The threshold level of VEGF-A ≤ 255.72 pg/ml (area under the ROC curve 0.630; 95 % confidence interval 0.534–0.719; p = 0.0472) was determined. A biomarker concentration below this level with a sensitivity of 72 % and a specificity of 58 % has a negative prognostic value for 6 months after STEMI. Multivariate regression logistic analysis of predictors of the combined endpoint showed that the level of VEGF-A, LDL-C, and the complicated course of the acute MI period are predictors of the adverse course of the disease (p = 0.005). Conclusions. In patients who reached the endpoint, a significantly lower concentration of VEGF-A was recorded (p = 0.011). A decrease in the level of VEGF-A < 255.72 pg/ml is a sensitive prognostic marker for the adverse course of the post-infarction period. The prognostic model for the development of adverse events during 6 months follow-up is constructed, with inclusion of the VEGF-A, LDL-C concentration and complications in the acute period of the disease, increases the accuracy of prediction power predominantly because of higher specificity.http://csic.com.ua/images/pdf/2020/2-2020/prognostic-role-vasculoendothelial-growth-factor-a-in-patients-with-acute-myocardial-infarction.pdfvasculoendothelial growth factor-ast segment elevation acute myocardial infarctionprognosis |
| spellingShingle | N.P. Kopytsya I.M. Кutya I.V. Rodionova Ya.V. Hilova The prognostic role of vasculoendothelial growth factor A in patients with ST-segment elevation acute myocardial infarction during 6-months follow-up period Кардіохірургія та інтервенційна кардіологія vasculoendothelial growth factor-a st segment elevation acute myocardial infarction prognosis |
| title | The prognostic role of vasculoendothelial growth factor A in patients with ST-segment elevation acute myocardial infarction during 6-months follow-up period |
| title_full | The prognostic role of vasculoendothelial growth factor A in patients with ST-segment elevation acute myocardial infarction during 6-months follow-up period |
| title_fullStr | The prognostic role of vasculoendothelial growth factor A in patients with ST-segment elevation acute myocardial infarction during 6-months follow-up period |
| title_full_unstemmed | The prognostic role of vasculoendothelial growth factor A in patients with ST-segment elevation acute myocardial infarction during 6-months follow-up period |
| title_short | The prognostic role of vasculoendothelial growth factor A in patients with ST-segment elevation acute myocardial infarction during 6-months follow-up period |
| title_sort | prognostic role of vasculoendothelial growth factor a in patients with st segment elevation acute myocardial infarction during 6 months follow up period |
| topic | vasculoendothelial growth factor-a st segment elevation acute myocardial infarction prognosis |
| url | http://csic.com.ua/images/pdf/2020/2-2020/prognostic-role-vasculoendothelial-growth-factor-a-in-patients-with-acute-myocardial-infarction.pdf |
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