Author + information
- Received December 26, 2017
- Revision received March 6, 2018
- Accepted March 7, 2018
- Published online April 18, 2018.
- Gianluca Pontone, MD, PhDa,∗ (, )
- Daniele Andreini, MD, PhDa,b,
- Andrea I. Guaricci, MDc,d,
- Marco Guglielmo, MDa,
- Andrea Baggiano, MDa,
- Giuseppe Muscogiuri, MDa,
- Laura Fusini, MDa,
- Fabio Fazzari, MDe,
- Claudio Berzovini, MDf,
- Annalisa Pasquini, MDg,
- Saima Mushtaq, MDa,
- Edoardo Conte, MDa,
- Nicola Cosentino, MDa,
- Mark G. Rabbat, MDh,i,
- Giancarlo Marenzi, MDa,
- Antonio L. Bartorelli, MDa,j,
- Mauro Pepi, MDa,
- Elena Tremoli, PhDa and
- Cristina Banfi, PhDa
- aCentro Cardiologico Monzino, IRCCS, Milan, Italy
- bDepartment of Cardiovascular Sciences and Community Health, University of Milan, Milan, Italy
- cInstitute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital “Policlinico” of Bari, Bari, Italy
- dDepartment of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
- eDepartment of Cardiology, University Hospital P. Giaccone, Palermo, Italy
- fDepartment of Surgical Sciences, Radiology Institute, University of Turin, Turin, Italy
- gDepartment of Cardiology, “La Sapienza” University of Rome, Rome, Italy
- hLoyola University of Chicago, Chicago, Illinois
- iEdward Hines Jr. VA Hospital, Hines, Illinois
- jDepartment of Biomedical and Clinical Sciences “Luigi Sacco,” University of Milan, Milan, Italy
- ↵∗Address for correspondence:
Dr. Gianluca Pontone, Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy.
Objectives This study aimed to evaluate the correlation between different haptoglobin (Hp) phenotypes and myocardial infarction characteristics as detected by cardiac magnetic resonance (CMR) in consecutive patients after ST-segment elevation myocardial infarction (STEMI).
Background Hp is a plasma protein that prevents iron-mediated oxidative tissue damage. CMR has emerged as the gold standard technique to detect left ventricular ejection fraction (LVEF), extent of scar with late gadolinium enhancement (LGE) technique, microvascular obstruction (MVO), and myocardial hemorrhage (MH) in patients with STEMI treated by primary percutaneous coronary intervention (pPCI).
Methods One hundred forty-five consecutive STEMI patients (mean age 62.2 ± 10.3 years; 78% men) were prospectively enrolled and underwent Hp phenotyping and CMR assessment within 1 week after STEMI.
Results CMR showed an area at risk (AAR) involving 26.6 ± 19.1% of left ventricular (LV) mass with a late LGE extent of 15.2 ± 13.1% of LV mass. MVO and MH occurred in 38 (26%) and 12 (8%) patients, respectively. Hp phenotypes 1-1, 2-1, 2-2 were observed in 15 (10%), 62 (43%), and 68 (47%), respectively. Multivariable analysis demonstrated that body mass index, Hp2-2, diabetes, and peak troponin I were independent predictors of MVO with Hp2-2 associated with the highest odds ratio (OR) (OR: 5.5 [95% confidence interval [CI]: 2.1 to 14.3; p < 0.001]). Hp2-2 significantly predicted both the presence (area under the curve [AUC]: 0.63 [95% CI: 0.53 to 0.72; p = 0.008]) and extent of MVO (AUC: 0.63 [95% CI: 0.54 to 0.72; p = 0.007]).
Conclusions Hp phenotype is an independent predictor of MVO. Therefore, Hp phenotyping could be used for risk stratification and may be useful in assessing new therapies to reduce myocardial reperfusion injury in patients with STEMI.
Dr. Pontone has received institutional research grant and/or speaker's fee from General Electric, Bracco, Bayer, Medtronic, and Heartflow. Dr. Bartorelli has served as a consultant for and has received a speaker’s fee from Abbott Vascular. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received December 26, 2017.
- Revision received March 6, 2018.
- Accepted March 7, 2018.
- 2018 American College of Cardiology Foundation