Restricted accessResearch articleFirst published online 2024-7
Investigating the Correlation between Serum Amyloid A and Infarct-Related Artery Patency Prior to Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction Patients
Serum amyloid A (SAA) is a cardiovascular risk factor and may serve as a predictor of infarct-related artery (IRA) patency in patients with ST-segment elevation myocardial infarction (STEMI). We measured SAA levels in STEMI patients who underwent percutaneous coronary intervention (PCI) and investigated their association with IRA patency. According to the Thrombolysis in Myocardial Infarction (TIMI) flow grade, 363 STEMI patients undergoing PCI in our hospital were divided into an occlusion group (TIMI 0-2) and a patency group (TIMI 3). The SAA level before PCI was significantly higher in STEMI patients with IRA occluded than in those with patent ones. At a cutoff value of 36.9 mg/L, SAA had a sensitivity of 63.0% and a specificity of 90.6% (area under the ROC curve [AUC] = .833, 95% CI: .793-.873, P < .001). Multivariate logistic regression analysis showed that SAA was an independent predictor of IRA patency in STEMI patients before PCI (odds ratio [OR] = 1.041, 95% CI: 1.020-1.062, P < .001). SAA can be used as a potential predictor of IRA patency in STEMI patients before PCI.
StoneGWCoxDGarciaE, et al.Normal flow (TIMI-3) before mechanical reperfusion therapy is an independent determinant of survival in acute myocardial infarction: analysis from the primary angioplasty in myocardial infarction trials. Circulation. 2001;104:636-641.
2.
RakowskiTDudekDDziewierzA, et al.Impact of infarct-related artery patency before primary PCI on outcome in patients with ST-segment elevation myocardial infarction: the HORIZONS-AMI trial. EuroIntervention. 2013;8:1307-1314.
3.
De LucaGErnstNZijlstraF, et al.Preprocedural TIMI flow and mortality in patients with acute myocardial infarction treated by primary angioplasty. J Am Coll Cardiol. 2004;43:1363-1367.
4.
LibbyP. Inflammation in atherosclerosis. Nature. 2002;420:868–874.
5.
LiJZhouYZhangY, et al.Admission homocysteine is an independent predictor of spontaneous reperfusion and early infarct-related artery patency before primary percutaneous coronary intervention in ST-segment elevation myocardial infarction. BMC Cardiovasc Disord. 2018;18:125.
6.
Gayretli YaylaKYaylaCErdolMA, et al.Relationship between c-reactive protein to albumin ratio and infarct-related artery patency in patients with ST-segment elevation myocardial infarction. Angiology. 2022;73:260-264.
7.
YaylaCAkbogaMKCanpolatU, et al.Platelet to lymphocyte ratio can be a predictor of infarct-related artery patency in patients with st-segment elevation myocardial infarction. Angiology. 2015;66:831-836.
8.
DoganMAkyelABilginM, et al.Can admission neutrophil to lymphocyte ratio predict infarct-related artery patency in ST-segment elevation myocardial infarction. Clin Appl Thromb Hemost. 2015;21:172-176.
9.
SackGHJr.Serum amyloid A - a review. Mol Med. 2018;24:46.
10.
LeowKYGohWWTanSZ, et al.Variant screening of the serum amyloid A1 gene and functional study of the p.Gly90Asp variant for its role in atherosclerosis. Atherosclerosis. 2013;227:112-117.
11.
ZhangYZhangJShengH, et al.Acute phase reactant serum amyloid A in inflammation and other diseases. Adv Clin Chem. 2019;90:25-80.
12.
ZewingerSDrechslerCKleberME, et al.Serum amyloid A: high-density lipoproteins interaction and cardiovascular risk. Eur Heart J. 2015;36:3007-3016.
13.
KosugeMEbinaTIshikawaT, et al.Serum amyloid A is a better predictor of clinical outcomes than C-reactive protein in non-ST-segment elevation acute coronary syndromes. Circ J. 2007;71:186-190.
14.
ThygesenKAlpertJSJaffeAS, et al.Fourth universal definition of myocardial infarction (2018). J Am Coll Cardiol. 2018;72:2231-2264.
15.
GibsonCMCannonCPMurphySA, et al.Relationship of the TIMI myocardial perfusion grades, flow grades, frame count, and percutaneous coronary intervention to long-term outcomes after thrombolytic administration in acute myocardial infarction. Circulation. 2002;105:1909-1913.
16.
RampidisGPBenetosGBenzDC, et al.A guide for Gensini Score calculation. Atherosclerosis. 2019;287:181-183.
17.
GensiniGG. A more meaningful scoring system for determining the severity of coronary heart disease. Am J Cardiol. 1983;51:606.
18.
WangKYZhengYYWuTT, et al.Predictive Value of gensini score in the long-term outcomes of patients with coronary artery disease who underwent PCI. Front Cardiovasc Med. 2021;8:778615.
19.
OprescuNMicheuMMScafa-UdristeA, et al.Inflammatory markers in acute myocardial infarction and the correlation with the severity of coronary heart disease. Ann Med. 2021;53:1041-1047.
20.
HeuschGGershBJ. The pathophysiology of acute myocardial infarction and strategies of protection beyond reperfusion: a continual challenge. Eur Heart J. 2017;38:774-784.
21.
JohnsonBDKipKEMarroquinOC, et al.Serum amyloid A as a predictor of coronary artery disease and cardiovascular outcome in women: the National heart, lung, and blood institute-sponsored women's ischemia syndrome evaluation (WISE). Circulation. 2004;109:726-732.
22.
ShinHCJangJSJinHY, et al.Combined Use of neutrophil to lymphocyte ratio and C-reactive protein level to predict clinical outcomes in acute myocardial infarction patients undergoing percutaneous coronary intervention. Korean Circ J. 2017;47:383-391.
23.
YildizIRencuzogullariIKarabagY, et al.Predictors of left ventricular ejection function decline in young patients with ST-segment elevation myocardial infarction. Rev Assoc Med Bras (1992). 2022;68:802-807.
24.
RakowskiTDudekDVan 'T HofA, et al.Impact of acute infarct-related artery patency before percutaneous coronary intervention on 30-day outcomes in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention in the EUROMAX trial. Eur Heart J Acute Cardiovasc Care. 2018;7:514-521.
25.
ZeymerUHuberKFuY, et al.Impact of TIMI 3 patency before primary percutaneous coronary intervention for ST-elevation myocardial infarction on clinical outcome: results from the ASSENT-4 PCI study. Eur Heart J Acute Cardiovasc Care. 2012;1:136-142.
26.
NaghaviMLibbyPFalkE, et al.From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: Part I. Circulation. 2003;108:1664-1672.
27.
KolodgieFDVirmaniRBurkeAP, et al.Pathologic assessment of the vulnerable human coronary plaque. Heart. 2004;90:1385-1391.
28.
HanssonGKHermanssonA. The immune system in atherosclerosis. Nat Immunol. 2011;12:204-212.
29.
GidronYGilutzHBergerR, et al.Molecular and cellular interface between behavior and acute coronary syndromes. Cardiovasc Res. 2002;56:15-21.
30.
HanssonGKLibbyPTabasI. Inflammation and plaque vulnerability. J Intern Med. 2015;278:483-493.
31.
GetzGSKrishackPAReardonCA. Serum amyloid A and atherosclerosis. Curr Opin Lipidol. 2016;27:531-535.
32.
KingVLThompsonJTannockLR. Serum amyloid A in atherosclerosis. Curr Opin Lipidol. 2011;22:302-307.
33.
AkyurekOAkbalEGunesF. Increase in the risk of ST elevation myocardial infarction is associated with homocysteine level. Arch Med Res. 2014;45:501-506.
34.
CinarTCagdasMRencuzogullariI, et al.Prognostic efficacy of C-reactive protein/albumin ratio in ST elevation myocardial infarction. Scand Cardiovasc J. 2019;53:83-90.
35.
FanYWangJZhangS, et al.Homocysteine enhances the predictive value of the GRACE risk score in patients with ST-elevation myocardial infarction. Anatol J Cardiol. 2017;18:182-193.
36.
FordjourPAWangYShiY, et al.Possible mechanisms of C-reactive protein mediated acute myocardial infarction. Eur J Pharmacol. 2015;760:72-80.
37.
SuleimanMKhatibRAgmonY, et al.Early inflammation and risk of long-term development of heart failure and mortality in survivors of acute myocardial infarction predictive role of C-reactive protein. J Am Coll Cardiol. 2006;47:962-968.
38.
YangYLWuCHHsuPF, et al.Systemic immune-inflammation index (SII) predicted clinical outcome in patients with coronary artery disease. Eur J Clin Invest. 2020;50:e13230.
39.
ZhangNAiyasidingXLiWJ, et al.Neutrophil degranulation and myocardial infarction. Cell Commun Signal. 2022;20:50.
40.
GaziEBayramBGaziS, et al.Prognostic value of the neutrophil-lymphocyte ratio in patients With ST-elevated acute myocardial infarction. Clin Appl Thromb Hemost. 2015;21:155-159.
41.
KurtulAYarliogluesMMuratSN, et al.Usefulness of the platelet-to-lymphocyte ratio in predicting angiographic reflow after primary percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction. Am J Cardiol. 2014;114:342-347.
42.
KalinskayaADukhinOLebedevaA, et al.Circulating cytokines in myocardial infarction are associated with coronary blood flow. Front Immunol. 2022;13:837642.
43.
HuaSSongCGeczyCL, et al.A role for acute-phase serum amyloid A and high-density lipoprotein in oxidative stress, endothelial dysfunction and atherosclerosis. Redox Rep. 2009;14:187-196.
44.
ChangCPanYDuH, et al.Serum amyloid A1 can be a novel biomarker for evaluating the presence and severity of acute coronary syndrome. Clin Biochem. 2020;85:27-32.
45.
BjorkmanLRaynesJGShahC, et al.The proinflammatory activity of recombinant serum amyloid A is not shared by the endogenous protein in the circulation. Arthritis Rheum. 2010;62:1660-1665.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
