Abstract 12107: Increased Expression and Plasma Levels of Neopterin are Associated with Left Ventricular Remodeling after Reperfusion in Patients with Acute Myocardial Infarction
Background: Neopterin is produced by activated monocytes/macrophages after stimulation by interferon-γ. In this study, we investigated whether plasma neopterin levels are associated with LV remodeling after reperfusion in patients with acute myocardial infarction (AMI).
Methods: Plasma neopterin levels were measured in patients with ST-segment elevation AMI (n=127), who underwent primary angioplasty within 12 hours of symptom onset. Measurements were takenat the acute phase (within 12 hours of AMI onset) and at the chronic phase (14 days after AMI onset), and the findings were related to LV remodeling following AMI. Left ventriculography was performed at the acute phase and at 6 months after AMI, and left ventricular end-diastolic volumes were calculated. In addition, we immunohistochemically examined the expression of neopterin in the infarcted myocardium from 11 autopsied patients, who died between 1 and 14 days after the onset of AMI.
Results: Plasma neopterin levels at the chronic phase were increased compared with the acute phase (21.2±16.7 vs.18.2±24.3 nmol/L, respectively; P<0.05).Thirty-five patients (28%) showed LV remodeling (≥20% end-diastolic volume increase). Plasma neopterin levels at the chronic phase were significantly higher in the group with than without remodeling (28.7±26.3 vs. 18.3±9.9 nmol/L, respectively; P<0.05). Multiple regression analysis showed that plasma neopterin levels at the chronic phase were a significant independent predictor of LV remodeling (OR, 1.067; 95% CI, 1.014 to 1.123; P=0.012). Immunohistochemical staining showed the percentage of the neopterin-positive area in the infarct myocardium was significantly higher (P<0.001) in the chronic phase (from 7 to 14 days after AMI onset) than in the acute phase (1 to 4 days after AMI onset). Double immunostaining for neopterin and macrophages revealed that the vast majority of neopterin-positive cells were macrophages.
Conclusions:These findings suggestthat increased expression and plasma levels of neopterin at the chronic phase are associated with left ventricular remodeling after reperfusion in patients with AMI.
- © 2012 by American Heart Association, Inc.