Neuropeptide-Y Levels in ST-Segment-Elevation Myocardial Infarction: Relationship With Coronary Microvascular Function, Heart Failure, and Mortality.

Content Provider	Europe PMC
Author	Gibbs, Thomas Tapoulal, Nidi Shanmuganathan, Mayooran Burrage, Matthew K. Borlotti, Alessandra Banning, Adrian P. Choudhury, Robin P. Neubauer, Stefan Kharbanda, Rajesh K. Ferreira, Vanessa M. Channon, Keith M. Herring, Neil
Abstract	BackgroundThe 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 ResultsNPY 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<0.001) and associated with multiple coronary and imaging parameters of microvascular function and infarct size (such as coronary flow reserve, acute myocardial edema, left ventricular ejection fraction, and late gadolinium enhancement 6 months later). We therefore assessed the prognostic value of PV NPY during follow‐up, where 34 patients (20.7%) developed heart failure or died. Kaplan‐Meier survival analysis demonstrated that high PV NPY levels (>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.ConclusionsBoth 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.
Page Count	13
Journal	Journal of the American Heart Association
Volume Number	11
PubMed Central reference number	PMC9333365
Issue Number	13
PubMed reference number	35766271
e-ISSN	20479980
DOI	10.1161/jaha.121.024850
Language	English
Publisher	John Wiley and Sons Inc.
Publisher Date	2022-06-29
Publisher Place	Hoboken
Access Restriction	Open
Rights License	This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
Subject Keyword	biomarker cardiovascular magnetic resonance imaging microvasculature percutaneous coronary intervention prognosis sympathetic cotransmitter Autonomic Nervous System Biomarkers Coronary Circulation Ischemia Risk Factors Heart Failure Myocardial Infarction Angiography Magnetic Resonance Imaging (MRI) Prognosis Percutaneous Coronary Intervention Revascularization Acute Coronary Syndromes Coronary Artery Disease
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine