Abstract 14723: High Levels of Stromal Cell-derived Factor-1α Predict Secondary Cardiac Events in Stable Patients With a History of Myocardial Infarction
Background: We recently showed that stromal cell-derived factor (SDF)-1α, a pro-inflammatory mediator, is produced in infarcted myocardium and is associated with progressive left ventricular (LV) dysfunction after acute myocardial infarction (AMI). This study examined whether SDF-1α levels in the peripheral vein (PV) can provide prognostic information of outcomes in stable patients with a history of MI.
Methods: Serum levels of SDF-1α in PV were measured by ELISA in 192 stable patients with a history of MI. All patients were followed prospectively for a period of 90 months or until occurrence of one of the following cardiac events: cardiac death, non-fatal myocardial infarction, unstable angina requiring unplanned PCI, or worsening heart failure requiring hospital admission.
Results: During the follow-up period (77 ± 26 months), 30 patients with MI had cardiac events. PV levels of SDF-1α were significantly higher in patients with than without events (2346; 2221-2504 vs. 2030; 1829-2300 pg/mL, respectively, p < 0.05). Multivariate Cox analysis revealed that high levels of SDF-1α (≥ 2162 pg/mL, determined by ROC analysis) were a significant predictor of cardiac events, independent of traditional risk factors (HR: 1.98; 95% CI: 1.38-2.85; p < 0.001). The addition of high levels of SDF-1α to conventional risk factors including BNP improved net reclassification improvement (NRI) and integrated discrimination improvement (IDI) (NRI 0.90, p < 0.0001; and IDI 0.05, p = 0.002).
Conclusions: High levels of SDF-1α in PV, which were released from LV in proportion to the severity of LV dysfunction, predicted secondary cardiac events in stable patients with a history of MI. SDF-1α levels may be a useful risk assessment tool in MI survivors.
Author Disclosures: S. Matsuoka: None. U. Manabu: None. T. Nakamura: None. T. Shimizu: None. M. Futamata: None. J. Obata: None. D. Fujioka: None. K. Nakamura: None. T. Yoshizaki: None. K. Kugiyama: None.
- © 2016 by American Heart Association, Inc.