Evaluation of Coronary Flow Level with Mots-C in Patients with STEMI Undergoing Primary PCI

Çakmak, Tolga; Yaşar, Erdoğan; Çakmak, Esin; Tekin, Suat; Karakuş, Yasin; Türkoğlu, Caner; Yüksel, Furkan

Acessibilidade / Reportar erro

Brasil

Arquivos Brasileiros de Cardiologia

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Article • Arq. Bras. Cardiol. 120 (1) • 2023 • https://doi.org/10.36660/abc.20220358 copy

Evaluation of Coronary Flow Level with Mots-C in Patients with STEMI Undergoing Primary PCI

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Background

The protective effects of mitochondrial open reading frame of the 12S rRNA-c (MOTS-C) on cardiovascular diseases have been shown in numerous studies. However, there is little documentation of the relationship between MOTS-C and coronary blood flow in ST-segment elevation myocardial infarction (STEMI).

Objective

We aimed to investigate the role of MOTS-C, which is known to have cytoprotective properties in the pathogenesis of the no-reflow phenomenon, by comparing the coronary flow rate and MOTS-C levels in patients with STEMI submitted to primary PCI.

Methods

52 patients with STEMI and 42 patients without stenosis >50% in the coronary arteries were included in the study. The STEMI group was divided into two groups according to post-PCI TIMI (Thrombolysis In Myocardial Infarction) flow grade:(i) No-reflow: grade 0, 1, and 2 and (ii) grade 3(angiographic success). A p value of <0.05 was considered significant.

Results

MOTS-C levels were significantly lower in the STEMI group compared to the control group (91.9 ± 8.9 pg/mL vs. 171.8±12.5 pg/mL, p<0.001). In addition, the Receiver Operating Characteristics (ROC) curve analysis indicated that serum MOTS-C levels had a diagnostic value in predicting no-reflow (Area Under the ROC curve [AUC]:0.95, 95% CI:0.856-0.993, p<0.001). A MOTS-C ≥84.15 pg/mL measured at admission was shown to have 95.3% sensitivity and 88.9% specificity in predicting no-reflow.

Conclusion

MOTS-C is a strong and independent predictor of no-reflow and in-hospital MACE in patients with STEMI. It was also noted that low MOTS-C levels may be an important prognostic marker of and may have a role in the pathogenesis of STEMI.

ST-elevation myocardial infarction; percutaneous coronary intervention; no-reflow phenomenon; open reading frames

Variable	STEMI (n=52)	Control (n=42)	p
Age (years)	59.2 ± 10.9	55.7 ± 8.2	0.04
Gender (male),n(%)	31 (59.6)	16 (38.1)	0.03
Smoking status, n (%)	24 (46.2)	25 (59.5)	0.27
BMI (kg/m2)*	26.3 (24.8-29.0)	28.7 (25.5-31.5)	0.03
Diabetes, n (%)	12 (23.1)	7 (16.7)	0.60
Hypertension, n (%)	15 (28.8)	9 (21.4)	0.48
Hyperlipidemia, n (%)	10 (19.2)	12 (28.6)	0.41
Vital signs
Systolic BP (mmHg)	133.6 ± 20.6	125.9 ± 16.3	0.06
Diastolic BP (mmHg)	80.8 ± 12.0	81.8 ± 9.2	0.65
Heart rate, beats/min	81.6 ± 13.8	78.6 ± 6.6	0.17
Biochemical parameters
Total cholesterol, mg/dL	199.4 ± 46.5	205.0 ± 40.7	0.54
HDL cholesterol, mg/dL	39.6 ± 7.9	49.4 ± 8.2	0.00
LDL cholesterol, mg/dL	125.1 ± 43.5	127.4 ± 29.4	0.77
Serum triglyceride, mg/dL*	180.0 (147.5-217.2)	143.5 (95.7-224.2)	0.03
Serum glucose, mg/dL	154.0 ± 74.5	142.3 ± 73.6	0.44
Blood urea nitrogen, mg/dL	35.6 ± 13.0	30.1 ± 11.7	0.03
Creatinine, mg/dL*	0.81 (0.75-0.94)	0.76 (0.68-0.91)	0.15
Hemoglobin (g/dL)	14.5 ± 1.8	13.3 ± 2.0	0.00
Leukocytes, x109/L*	12.2 (9.4-14.8)	6.2 (5.3-8.5)	0.00
Platelets, x109/L	258 ± 59	268 ± 67	0.45

Variable	TIMI 0, 1, 2 (n=9)	TIMI 3 (n=43)	p
Age (years)	54.7 ± 11.2	60.2 ± 10.7	0.17
Gender (male)	4 (44.4)	27 (62.8)	0.45
Smoking status, n (%)	3 (33.3)	21 (48.8)	0.48
BMI (kg/m2)*	29.0 (26.2-31.1)	25.8 (24.2-28.3)	0.03
Diabetes, n (%)	2 (22.2)	10 (23.3)	0.94
Hypertension, n (%)	2 (22.2)	13 (30.2)	0.71
Hyperlipidemia, n (%)	1 (11.1)	9 (20.9)	0.67
Previous medications, n (%)
ASA	1 (11.1)	12 (27.9)	0.42
Beta Blocker	0 (00.0)	6 (14.0)	0.35
ACEI-ARB	2 (22.2)	12 (27.9)	0.72
Statin	1 (11.1)	6 (14.0)	0.82
Ca CB	0 (0.00)	10 (23.3)	0.17
Hydrochlorothiazide	1 (11.1)	4 (9.3)	0.86
Furosemide	0 (0.00)	2 (4.7)	0.50
Vital signs
Systolic BP (mmHg)	132.3 ± 22.6	133.9 ± 20.4	0.83
Diastolic BP (mmHg)	78.3 ± 13.2	81.3 ± 11.9	0.50
Heart rate, beats/min	81.1 ± 15.2	81.7 ± 13.7	0.90
Biochemical parameters
Total cholesterol, mg/dL	210.4 ± 26.6	197.1 ± 49.7	0.44
HDL cholesterol, mg/dL	41.0 ± 9.4	39.3 ± 7.7	0.64
LDL cholesterol, mg/dL	135.9 ± 34.2	122.9 ± 45.2	0.41
Serum triglycerides, mg/dL*	166.0 (122.0-263.0)	129.0 (89.0-225.0)	0.28
Serum glucose, mg/dL*	133.0 (101.9-220.5)	127.0 (102.0-178.0)	0.79
Blood urea nitrogen, mg/dL	29.8 ± 7.3	36.9 ± 13.6	0.20
Creatinine, mg/dL	0.84 ± 0.11	0.84 ± 0.19	0.83
Hemoglobin (g/dL)	15.1 ± 2.1	14.4 ± 1.8	0.35
Leukocytes, x109/L*	11.3 (9.7-12.9)	12.3 (9.4-15.2)	0.57
Platelets, x109/L	238 ± 56	262 ± 59	0.26
Coronary artery involvement
Single-vessel disease	3 (33.3)	20 (46.5)	0.71
Multivessel disease	6 (66.7)	23 (53.5)	0.71
Primary PCI
Stent implantation, n (%)	7 (77.8)	43 (100)	0.02
BMS, n (%)	2 (22.2)	6 (14.0)	0.61
DES, n (%)	5 (55.6)	37 (86.0)	0.06
Stent length (mm)	25.8 ± 6.6	24.3 ± 6.7	0.57
Stent diameter (mm)	3.1 ± 0.5	2.9 ± 0.3	0.39
In-hospital MACE, n (%)	3 (33.3)	1 (2.3)	0.01

Variable	MOTS-C< 84.15	MOTS-C ≥ 84.15	p
Age (years)	59.4 ± 12.1	59.2 ± 10.7	0.96
Gender (male), n (%)	5 (50.0)	26 (61.9)	0.49
Smoking status, n (%)	3 (30.0)	21 (50.0)	0.30
BMI (kg/m²)*	27.4 (25.3-30.4)	26.2 (24.3-28.5)	0.28
Diabetes, n (%)	2 (20.0)	10 (23.8)	0.79
Hypertension, n (%)	2 (20.0)	13 (31.0)	0.70
Hyperlipidemia, n (%)	1 (10.0)	9 (21.4)	0.66
Single-vessel disease	4 (40.0)	19 (45.2)	0.76
Multivessel disease	6 (60.0)	23 (54.8)	0.76
In-hospital MACE, n (%)	3 (30.0)	1 (2.4)	0.01

Variable	Unadjusted OR	95% Cl	p	Adjusted OR	95% Cl	p
Age	1.053	0.976-1.137	0.180	1.051	0.926-1.193	0.442
Gender	2.109	0.493-9.019	0.314
Smoking status	1.909	0.422-8.637	0.401
BMI	0.970	0.789-1.042	0.166	0.754	0.484-1.173	0.210
Diabetes	1.061	0.189-5.943	0.947
Hypertension	1.517	0.277-8.310	0.631
Hyperlipidemia	2.118	0.234-19.20	0.505
MOTS-C	1.606	1.123-2.296	0.009	2.394	1.101-5.205	0.012

Sociedade Brasileira de Cardiologia - SBC Avenida Marechal Câmara, 160, sala: 330, Centro, CEP: 20020-907, (21) 3478-2700 - Rio de Janeiro - RJ - Brazil, Fax: +55 21 3478-2770 - São Paulo - SP - Brazil
E-mail: revista@cardiol.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Mailing Address: Tolga Çakmak • Department of Cardiology, Balıkesir Atatürk City Hospital, Balıkesir – Turkey E-mail: tolgacakmak85@gmail.com