Neuropeptide‐Y Levels in ST‐Segment–Elevation Myocardial Infarction: Relationship With Coronary Microvascular Function, Heart Failure, and Mortality
Open Access
- 29 June 2022
- journal article
- research article
- Published by Wolters Kluwer Health in Journal of the American Heart Association
- Vol. 11 (13) , e024850
Abstract
Background: The sympathetic cotransmitter, neuropeptide Y (NPY), is released into the coronary sinus during ST‐segment–elevation myocardial infarction and can constrict the coronary microvasculature. We sought to establish whether peripheral venous (PV) NPY levels, which are easy to obtain and measure, are associated with microvascular obstruction, myocardial recovery, and prognosis. Methods and Results: NPY levels were measured immediately after primary percutaneous coronary intervention and compared with angiographic and cardiovascular magnetic resonance indexes of microvascular function. Patients were prospectively followed up for 6.4 (interquartile range, 4.1–8.0) years. PV (n=163) and coronary sinus (n=68) NPY levels were significantly correlated ( r =0.92; P 21.4 pg/mL by binary recursive partitioning) were associated with increased incidence of heart failure and mortality (hazard ratio, 3.49 [95% CI, 1.65–7.4]; P <0.001). This relationship was maintained after adjustment for age, cardiovascular risk factors, and previous myocardial infarction. Conclusions: Both PV and coronary sinus NPY levels correlate with microvascular function and infarct size after ST‐segment–elevation myocardial infarction. PV NPY levels are associated with the subsequent development of heart failure or mortality and may therefore be a useful prognostic marker. Further research is required to validate these findings.Keywords
This publication has 31 references indexed in Scilit:
- Relationship of plasma neuropeptide Y with angiographic, electrocardiographic and coronary physiology indices of reperfusion during ST elevation myocardial infarctionHeart, 2013
- The cardiac sympathetic co-transmitter galanin reduces acetylcholine release and vagal bradycardia: Implications for neural control of cardiac excitabilityJournal of Molecular and Cellular Cardiology, 2012
- Impact of early vs. late microvascular obstruction assessed by magnetic resonance imaging on long-term outcome after ST-elevation myocardial infarction: a comparison with traditional prognostic markersEuropean Heart Journal, 2010
- Plasma levels of thromboxane A2 on admission are associated with no-reflow after primary percutaneous coronary interventionEuropean Heart Journal, 2008
- Infarct size by contrast enhanced cardiac magnetic resonance is a stronger predictor of outcomes than left ventricular ejection fraction or end-systolic volume index: prospective cohort studyHeart, 2008
- Endothelin-1 and acute myocardial infarction: a no-reflow mediator after successful percutaneous myocardial revascularizationEuropean Heart Journal, 2006
- Region-Specific Neuropeptide Y Overflows at Rest and During Sympathetic Activation in HumansHypertension, 1997
- Neuropeptide-Y. A peptide found in human coronary arteries constricts primarily small coronary arteries to produce myocardial ischemia in dogs.Journal of Clinical Investigation, 1989
- CORONARY ARTERY INFUSION OF NEUROPEPTIDE Y IN PATIENTS WITH ANGINA PECTORISThe Lancet, 1987
- The “No-Reflow” Phenomenon after Temporary Coronary Occlusion in the DogJournal of Clinical Investigation, 1974