Journal
INTERNATIONAL JOURNAL OF CARDIOLOGY
Volume 370, Issue -, Pages 43-50Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.ijcard.2022.10.142
Keywords
STEMI; Metabolic syndrome; Inflammation; Remodeling; Ejection fraction
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This study analyzed the relationships between BMI, other components of metabolic syndrome, and inflammatory markers with left ventricular geometry, function, and infarct size after ST-elevation MI. The results showed that BMI, HbA1c, and peak CRP were independent predictors of worse LVEF early after MI, while only peak CRP predicted worse LVEF at later stages.
Background: A high body mass index (BMI) is often associated with metabolic syndrome, which is accompanied by systemic low-grade chronic inflammation. Here, we analyzed whether BMI, other components of metabolic syndrome, and/or inflammatory markers correlate with left ventricular geometry, function, and infarct size as assessed by serial cardiac magnetic resonance imaging (MRI) after a first (clinically evident) ST-elevation MI (STEMI).Methods: Within the Etiology, Titre-Course, and effect on Survival (ETiCS) study, cardiac MRI conducted 7-9 days and 12 months after MI enabled longitudinal characterization of patients with a first STEMI along with serial routine blood counts and multiplex cytokine measurements.Results: Of 91 locally included STEMI patients, 47% were overweight (25 kg/m2 < BMI < 30 kg/m2) and 24% were obese (BMI >= 30 kg/m2). No patient died during 12 months of follow-up. Left ventricular ejection fraction (LVEF), measured 7-9 days after STEMI, was significantly lower in overweight (49.5 +/- 7.1%) and obese (45.8 +/- 12.0%) patients than in the normal weight group (56.2 +/- 7.7%). Along with BMI (T =-3.8; p < 0.001), he-moglobin A1c (HbA1c; T =-3.1; p = 0.004) and peak C-reactive protein (T =-2.6; p = 0.013) emerged as in-dependent predictors of worse LVEF 7-9 days post MI (R2 = 0.45). Only peak C-reactive protein (T =-4.4; p < 0.001), but not parameters of the metabolic syndrome, predicted worse LVEF 12 months after STEMI (R2 = 0.20).Conclusion: Both BMI and HbA1c correlated negatively with LVEF only early, but not late after STEMI. Peak CRP evolved as strongest predictor of cardiac function at all time points independent of the metabolic syndrome.
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