Relation of a novel fibrosis marker and post-myocardial infarction left ventricular ejection fraction in revascularized patients

• Published in: Biomarkers in medicine 2021-12, Vol.15 (17), p.1651-1658
• Main Authors: Kilci, Hakan, Altınbilek, Ertuğrul, Çetinkal, Gökhan, Sığırcı, Serhat, Koçaş, Betül B, Yıldız, Süleyman S, Kılıçkesmez, Kadriye Orta
• Format: Article
• Language: English
• Subjects: heart failure; human epididymis factor-4; left ventricular systolic dysfunction; ST-segment elevation myocardial infarction
• ISSN: 1752-0363; 1752-0371
• DOI: 10.2217/bmm-2021-0003

To investigate the relationship between post-myocardial infarction (MI) left ventricular ejection fraction (LVEF) and fibrosis marker HE-4 in primarily revascularized patients with ST-segment elevation MI (STEMI). In 94 consecutive STEMI patients (median age 57 [IQR: 50–69] years; 77.7% male), HE-4 values were measured at hospital admission and 4 days after STEMI. Transthoracic echocardiography was performed 4 days after STEMI (median 5 days [interquartile range: 4–6]). HE-4 levels 4 days after STEMI were significantly higher in the low ejection fraction group (30.1 [26.0–46.5] pmol/l vs 48.5 [32.5–85.9] pmol/l, p = 0.004). In the multivariable analysis, HE-4 values (odds ratio: 1.029, 95% CI: 1.012–1.046, p = 0.001), troponin I levels, anterior MI and diabetes mellitus were independent predictors of low LVEF after STEMI. A negative correlation existed between ΔHE-4 levels and LVEF (r: -0.337, p = 0.001). Receiver operating characteristic analysis indicated 34.01 pmol/l HE-4 at 4 days after STEMI identified patients with low LVEF (AUC = 0.707; 95% CI: 0.601–0.813; p = 0.001). In revascularized STEMI patients, high HE-4 levels are associated with decreased LVEF. HE-4 may represent a diagnostic marker and treatment target for patients with heart failure or left ventricular systolic dysfunction after STEMI.