Risk factors and prognostic value of endotoxemia in patients with acute myocardial infarction

There is increasing evidence regarding the association between endotoxemia and the pathogenesis of atherosclerosis and myocardial infarction (MI). During the acute phase of MI, endotoxemia might increase inflammation and drive adverse cardiovascular (CV) outcomes. We aimed to explore the risk factor...

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Published in:Frontiers in cardiovascular medicine 2024-06, Vol.11, p.1419001
Main Authors: Nguyen, Maxime, Putot, Alain, Masson, David, Cottin, Yves, Gautier, Thomas, Tribouillard, Laura, Rérole, Anne-Laure, Guinot, Pierre-Grégoire, Maza, Maud, Pais de Barros, Jean-Paul, Deckert, Valérie, Farnier, Michel, Lagrost, Laurent, Zeller, Marianne
Format: Article
Language:English
Subjects:
acute myocardial infarction
Cardiovascular Medicine
diabetes
endotoxemia
inflammation
lipopolysaccharide
lipoprotein
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Summary:There is increasing evidence regarding the association between endotoxemia and the pathogenesis of atherosclerosis and myocardial infarction (MI). During the acute phase of MI, endotoxemia might increase inflammation and drive adverse cardiovascular (CV) outcomes. We aimed to explore the risk factors and prognostic value of endotoxemia in patients admitted for acute MI. Patients admitted to the coronary care unit of Dijon University Hospital for type 1 acute MI between 2013 and 2015 were included. Endotoxemia, assessed by plasma lipopolysaccharide (LPS) concentration, was measured by mass spectrometry. Major adverse CV events were recorded in the year following hospital admission. Data from 245 consecutive MI patients were analyzed. LPS concentration at admission markedly increased with age and diabetes. High LPS concentration was correlated with metabolic biomarkers (glycemia, triglyceride, and total cholesterol) but not with CV (troponin Ic peak and N-terminal pro-brain natriuretic peptide) or inflammatory biomarkers (C-reactive protein, IL6, IL8, and TNFα). LPS concentration was not associated with in-hospital or 1-year outcomes. In patients admitted for MI, higher levels of endotoxins were related to pre-existing conditions rather than acute clinical severity. Therefore, endotoxins measured on the day of MI could reflect metabolic chronic endotoxemia rather than MI-related acute gut translocation.
ISSN:2297-055X
2297-055X
DOI:10.3389/fcvm.2024.1419001