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01.09.2015 | Original article

Role of cathepsin D activation in major adverse cardiovascular events and new-onset heart failure after STEMI

verfasst von: Aylin Hatice Yamac, M.D., Emrah Sevgili, M.D., Sitki Kucukbuzcu, M.D., Muharrem Nasifov, M.D., Ziya Ismailoglu, M.D., Elif Kilic, M.D., Cilem Ercan, M.D., Parviz Jafarov, M.D., Hüseyin Uyarel, M.D., Ahmet Bacaksiz, M.D.

Erschienen in: Herz | Ausgabe 6/2015

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Abstract

Aim

Increased serum levels of the activated aspartic lysosomal endopeptidase cathepsin D (CatD) have been found in patients with acute myocardial infarction (AMI). However, to date there have been no analyses of clinical follow-up data measuring the enzyme course and its role in the development of post-MI heart failure. This study aimed to evaluate the role of serum CatD activity in the development of heart failure in patients with ST-segment elevation acute myocardial infarction (STEMI).

Patients and methods

Eighty-eight consecutive patients (79.5 % men, mean age 57.4 ± 10.2 years) with STEMI were included in this study. Serum CatD activity was measured directly after primary percutaneous coronary intervention (PCI), before discharge, and at the 6-month follow-up. Patients were monitored for major adverse cardiovascular events (MACE), defined as hospitalization due to cardiovascular causes, recurrent nonfatal myocardial infarction, unplanned PCI, new-onset heart failure, and cardiovascular mortality.

Results

Serum CatD activity was significantly higher in patients with AMI after PCI and during follow-up (FU) than that in age-matched controls (16.2 ± 7.5 and 29.8 ± 8.9 vs. 8.5 ± 4.2 RFU; p < 0.001 for each time point). At the 6-month follow-up, serum CatD activity in these patients was inversely related to new-onset cardiac dysfunction compared with patients with preserved and improved LVEF after treatment (23.1 ± 3.2 vs. 28.8 ± 7.0 and 29.7 ± 5.0 RFU respectively, p < 0.01). Patients suffering from MACE during a follow-up period of 6 months had lower serum levels of activated CatD than those without any MACE (23.8 ± 4.6 vs 29.6 ± 6.9 RFU; p < 0.001).

Conclusions

Serum CatD activity as a marker of healthy endogenous phagocytosis and remodeling was impaired in patients with new-onset cardiac dysfunction, and lower levels of serum CatD were associated with MACE at the 6-month post-MI follow-up.

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Titel: Role of cathepsin D activation in major adverse cardiovascular events and new-onset heart failure after STEMI
verfasst von: Aylin Hatice Yamac, M.D.
Emrah Sevgili, M.D.
Sitki Kucukbuzcu, M.D.
Muharrem Nasifov, M.D.
Ziya Ismailoglu, M.D.
Elif Kilic, M.D.
Cilem Ercan, M.D.
Parviz Jafarov, M.D.
Hüseyin Uyarel, M.D.
Ahmet Bacaksiz, M.D.
Publikationsdatum: 01.09.2015
Verlag: Urban & Vogel
Erschienen in: Herz / Ausgabe 6/2015
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI: https://doi.org/10.1007/s00059-015-4311-6

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Role of cathepsin D activation in major adverse cardiovascular events and new-onset heart failure after STEMI

Abstract