Association of Intramyocardial Hemorrhage With Inflammatory Biomarkers in Patients With ST-Segment Elevation Myocardial Infarction
Ischemia-reperfusion (I/R) injury patterns detected by cardiac magnetic resonance imaging after percutaneous coronary intervention (PCI) have important prognostic implications and trigger inflammatory processes that can further enhance myocardial tissue damage. The authors aimed to investigate the a...
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| Published in | JACC. Advances (Online) Vol. 4; no. 4; p. 101647 |
|---|---|
| Main Authors | , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Elsevier Inc
01.04.2025
Elsevier |
| Subjects | |
| Online Access | Get full text |
| ISSN | 2772-963X 2772-963X |
| DOI | 10.1016/j.jacadv.2025.101647 |
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| Abstract | Ischemia-reperfusion (I/R) injury patterns detected by cardiac magnetic resonance imaging after percutaneous coronary intervention (PCI) have important prognostic implications and trigger inflammatory processes that can further enhance myocardial tissue damage.
The authors aimed to investigate the association of circulating inflammatory markers and I/R injury patterns in patients with ST-segment elevation myocardial infarction (STEMI).
This observational study included 456 STEMI patients. Peripheral venous blood samples were drawn 48 hours after PCI for analysis of high-sensitivity C-reactive protein (hs-CRP), white blood cell count (WBCc), and interleukin (IL)-6. The presence of I/R injury was defined by the detection of intramyocardial hemorrhage (IMH) according to cardiac magnetic resonance T2∗. Clinical endpoint was the occurrence of major adverse cardiac events, defined as composite of all-cause death, nonfatal reinfarction, and new congestive heart failure.
IMH was present in 150 (33%) patients. Hs-CRP (OR: 2.89; 95% CI: 1.96-4.26; P < 0.001), WBCc (OR: 1.32; 95% CI: 1.04-1.67; P = 0.021), and IL-6 (OR: 1.86; 95% CI: 1.38-2.51; P < 0.001) were associated with presence of IMH. Only hs-CRP was independently associated with IMH (OR: 1.95; 95% CI: 1.30-2.93; P = 0.001) after adjustment for other clinical parameters. Furthermore, patients with hs-CRP levels above the median (>26.4 mg/L) were more likely to experience major adverse cardiac events (12% vs 4%, P = 0.002) during a median follow-up of 12 (Q1-Q3: 12-13) months.
In patients with STEMI treated with primary PCI, inflammatory parameters including hs-CRP, WBCc, and IL-6 were significantly associated with I/R injury as defined by IMH. After adjustment for other factors, hs-CRP was the only independent inflammatory biomarker associated with IMH.
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| AbstractList | Ischemia-reperfusion (I/R) injury patterns detected by cardiac magnetic resonance imaging after percutaneous coronary intervention (PCI) have important prognostic implications and trigger inflammatory processes that can further enhance myocardial tissue damage.
The authors aimed to investigate the association of circulating inflammatory markers and I/R injury patterns in patients with ST-segment elevation myocardial infarction (STEMI).
This observational study included 456 STEMI patients. Peripheral venous blood samples were drawn 48 hours after PCI for analysis of high-sensitivity C-reactive protein (hs-CRP), white blood cell count (WBCc), and interleukin (IL)-6. The presence of I/R injury was defined by the detection of intramyocardial hemorrhage (IMH) according to cardiac magnetic resonance T2∗. Clinical endpoint was the occurrence of major adverse cardiac events, defined as composite of all-cause death, nonfatal reinfarction, and new congestive heart failure.
IMH was present in 150 (33%) patients. Hs-CRP (OR: 2.89; 95% CI: 1.96-4.26; P < 0.001), WBCc (OR: 1.32; 95% CI: 1.04-1.67; P = 0.021), and IL-6 (OR: 1.86; 95% CI: 1.38-2.51; P < 0.001) were associated with presence of IMH. Only hs-CRP was independently associated with IMH (OR: 1.95; 95% CI: 1.30-2.93; P = 0.001) after adjustment for other clinical parameters. Furthermore, patients with hs-CRP levels above the median (>26.4 mg/L) were more likely to experience major adverse cardiac events (12% vs 4%, P = 0.002) during a median follow-up of 12 (Q1-Q3: 12-13) months.
In patients with STEMI treated with primary PCI, inflammatory parameters including hs-CRP, WBCc, and IL-6 were significantly associated with I/R injury as defined by IMH. After adjustment for other factors, hs-CRP was the only independent inflammatory biomarker associated with IMH. Ischemia-reperfusion (I/R) injury patterns detected by cardiac magnetic resonance imaging after percutaneous coronary intervention (PCI) have important prognostic implications and trigger inflammatory processes that can further enhance myocardial tissue damage. The authors aimed to investigate the association of circulating inflammatory markers and I/R injury patterns in patients with ST-segment elevation myocardial infarction (STEMI). This observational study included 456 STEMI patients. Peripheral venous blood samples were drawn 48 hours after PCI for analysis of high-sensitivity C-reactive protein (hs-CRP), white blood cell count (WBCc), and interleukin (IL)-6. The presence of I/R injury was defined by the detection of intramyocardial hemorrhage (IMH) according to cardiac magnetic resonance T2∗. Clinical endpoint was the occurrence of major adverse cardiac events, defined as composite of all-cause death, nonfatal reinfarction, and new congestive heart failure. IMH was present in 150 (33%) patients. Hs-CRP (OR: 2.89; 95% CI: 1.96-4.26; P < 0.001), WBCc (OR: 1.32; 95% CI: 1.04-1.67; P = 0.021), and IL-6 (OR: 1.86; 95% CI: 1.38-2.51; P < 0.001) were associated with presence of IMH. Only hs-CRP was independently associated with IMH (OR: 1.95; 95% CI: 1.30-2.93; P = 0.001) after adjustment for other clinical parameters. Furthermore, patients with hs-CRP levels above the median (>26.4 mg/L) were more likely to experience major adverse cardiac events (12% vs 4%, P = 0.002) during a median follow-up of 12 (Q1-Q3: 12-13) months. In patients with STEMI treated with primary PCI, inflammatory parameters including hs-CRP, WBCc, and IL-6 were significantly associated with I/R injury as defined by IMH. After adjustment for other factors, hs-CRP was the only independent inflammatory biomarker associated with IMH. [Display omitted] Ischemia-reperfusion (I/R) injury patterns detected by cardiac magnetic resonance imaging after percutaneous coronary intervention (PCI) have important prognostic implications and trigger inflammatory processes that can further enhance myocardial tissue damage.BACKGROUNDIschemia-reperfusion (I/R) injury patterns detected by cardiac magnetic resonance imaging after percutaneous coronary intervention (PCI) have important prognostic implications and trigger inflammatory processes that can further enhance myocardial tissue damage.The authors aimed to investigate the association of circulating inflammatory markers and I/R injury patterns in patients with ST-segment elevation myocardial infarction (STEMI).OBJECTIVESThe authors aimed to investigate the association of circulating inflammatory markers and I/R injury patterns in patients with ST-segment elevation myocardial infarction (STEMI).This observational study included 456 STEMI patients. Peripheral venous blood samples were drawn 48 hours after PCI for analysis of high-sensitivity C-reactive protein (hs-CRP), white blood cell count (WBCc), and interleukin (IL)-6. The presence of I/R injury was defined by the detection of intramyocardial hemorrhage (IMH) according to cardiac magnetic resonance T2∗. Clinical endpoint was the occurrence of major adverse cardiac events, defined as composite of all-cause death, nonfatal reinfarction, and new congestive heart failure.METHODSThis observational study included 456 STEMI patients. Peripheral venous blood samples were drawn 48 hours after PCI for analysis of high-sensitivity C-reactive protein (hs-CRP), white blood cell count (WBCc), and interleukin (IL)-6. The presence of I/R injury was defined by the detection of intramyocardial hemorrhage (IMH) according to cardiac magnetic resonance T2∗. Clinical endpoint was the occurrence of major adverse cardiac events, defined as composite of all-cause death, nonfatal reinfarction, and new congestive heart failure.IMH was present in 150 (33%) patients. Hs-CRP (OR: 2.89; 95% CI: 1.96-4.26; P < 0.001), WBCc (OR: 1.32; 95% CI: 1.04-1.67; P = 0.021), and IL-6 (OR: 1.86; 95% CI: 1.38-2.51; P < 0.001) were associated with presence of IMH. Only hs-CRP was independently associated with IMH (OR: 1.95; 95% CI: 1.30-2.93; P = 0.001) after adjustment for other clinical parameters. Furthermore, patients with hs-CRP levels above the median (>26.4 mg/L) were more likely to experience major adverse cardiac events (12% vs 4%, P = 0.002) during a median follow-up of 12 (Q1-Q3: 12-13) months.RESULTSIMH was present in 150 (33%) patients. Hs-CRP (OR: 2.89; 95% CI: 1.96-4.26; P < 0.001), WBCc (OR: 1.32; 95% CI: 1.04-1.67; P = 0.021), and IL-6 (OR: 1.86; 95% CI: 1.38-2.51; P < 0.001) were associated with presence of IMH. Only hs-CRP was independently associated with IMH (OR: 1.95; 95% CI: 1.30-2.93; P = 0.001) after adjustment for other clinical parameters. Furthermore, patients with hs-CRP levels above the median (>26.4 mg/L) were more likely to experience major adverse cardiac events (12% vs 4%, P = 0.002) during a median follow-up of 12 (Q1-Q3: 12-13) months.In patients with STEMI treated with primary PCI, inflammatory parameters including hs-CRP, WBCc, and IL-6 were significantly associated with I/R injury as defined by IMH. After adjustment for other factors, hs-CRP was the only independent inflammatory biomarker associated with IMH.CONCLUSIONSIn patients with STEMI treated with primary PCI, inflammatory parameters including hs-CRP, WBCc, and IL-6 were significantly associated with I/R injury as defined by IMH. After adjustment for other factors, hs-CRP was the only independent inflammatory biomarker associated with IMH. AbstractBackgroundIschemia-reperfusion (I/R) injury patterns detected by cardiac magnetic resonance imaging after percutaneous coronary intervention (PCI) have important prognostic implications and trigger inflammatory processes that can further enhance myocardial tissue damage. ObjectivesThe authors aimed to investigate the association of circulating inflammatory markers and I/R injury patterns in patients with ST-segment elevation myocardial infarction (STEMI). MethodsThis observational study included 456 STEMI patients. Peripheral venous blood samples were drawn 48 hours after PCI for analysis of high-sensitivity C-reactive protein (hs-CRP), white blood cell count (WBCc), and interleukin (IL)-6. The presence of I/R injury was defined by the detection of intramyocardial hemorrhage (IMH) according to cardiac magnetic resonance T2∗. Clinical endpoint was the occurrence of major adverse cardiac events, defined as composite of all-cause death, nonfatal reinfarction, and new congestive heart failure. ResultsIMH was present in 150 (33%) patients. Hs-CRP (OR: 2.89; 95% CI: 1.96-4.26; P < 0.001), WBCc (OR: 1.32; 95% CI: 1.04-1.67; P = 0.021), and IL-6 (OR: 1.86; 95% CI: 1.38-2.51; P < 0.001) were associated with presence of IMH. Only hs-CRP was independently associated with IMH (OR: 1.95; 95% CI: 1.30-2.93; P = 0.001) after adjustment for other clinical parameters. Furthermore, patients with hs-CRP levels above the median (>26.4 mg/L) were more likely to experience major adverse cardiac events (12% vs 4%, P = 0.002) during a median follow-up of 12 (Q1-Q3: 12-13) months. ConclusionsIn patients with STEMI treated with primary PCI, inflammatory parameters including hs-CRP, WBCc, and IL-6 were significantly associated with I/R injury as defined by IMH. After adjustment for other factors, hs-CRP was the only independent inflammatory biomarker associated with IMH. |
| ArticleNumber | 101647 |
| Author | Oberhollenzer, Fritz Reinstadler, Sebastian J. Lechner, Ivan Pamminger, Mathias Holzknecht, Magdalena Bauer, Axel von der Emde, Sebastian Reindl, Martin Tiller, Christina Metzler, Bernhard Mayr, Agnes Kaser, Alex Gollmann-Tepeköylü, Can |
| Author_xml | – sequence: 1 givenname: Christina surname: Tiller fullname: Tiller, Christina organization: Cardiology and Angiology, Medical University of Innsbruck, University Clinic of Internal Medicine III, Innsbruck, Austria – sequence: 2 givenname: Martin surname: Reindl fullname: Reindl, Martin organization: Cardiology and Angiology, Medical University of Innsbruck, University Clinic of Internal Medicine III, Innsbruck, Austria – sequence: 3 givenname: Magdalena surname: Holzknecht fullname: Holzknecht, Magdalena organization: Cardiology and Angiology, Medical University of Innsbruck, University Clinic of Internal Medicine III, Innsbruck, Austria – sequence: 4 givenname: Ivan orcidid: 0000-0003-1379-3233 surname: Lechner fullname: Lechner, Ivan organization: Cardiology and Angiology, Medical University of Innsbruck, University Clinic of Internal Medicine III, Innsbruck, Austria – sequence: 5 givenname: Fritz surname: Oberhollenzer fullname: Oberhollenzer, Fritz organization: Cardiology and Angiology, Medical University of Innsbruck, University Clinic of Internal Medicine III, Innsbruck, Austria – sequence: 6 givenname: Sebastian surname: von der Emde fullname: von der Emde, Sebastian organization: Cardiology and Angiology, Medical University of Innsbruck, University Clinic of Internal Medicine III, Innsbruck, Austria – sequence: 7 givenname: Alex surname: Kaser fullname: Kaser, Alex organization: Cardiology and Angiology, Medical University of Innsbruck, University Clinic of Internal Medicine III, Innsbruck, Austria – sequence: 8 givenname: Agnes orcidid: 0000-0001-9363-873X surname: Mayr fullname: Mayr, Agnes organization: Medical University of Innsbruck, University Clinic of Radiology, Innsbruck, Austria – sequence: 9 givenname: Mathias surname: Pamminger fullname: Pamminger, Mathias organization: Medical University of Innsbruck, University Clinic of Radiology, Innsbruck, Austria – sequence: 10 givenname: Can surname: Gollmann-Tepeköylü fullname: Gollmann-Tepeköylü, Can organization: University Clinic of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria – sequence: 11 givenname: Axel surname: Bauer fullname: Bauer, Axel organization: Cardiology and Angiology, Medical University of Innsbruck, University Clinic of Internal Medicine III, Innsbruck, Austria – sequence: 12 givenname: Bernhard surname: Metzler fullname: Metzler, Bernhard organization: Cardiology and Angiology, Medical University of Innsbruck, University Clinic of Internal Medicine III, Innsbruck, Austria – sequence: 13 givenname: Sebastian J. orcidid: 0000-0002-7700-1357 surname: Reinstadler fullname: Reinstadler, Sebastian J. email: Sebastian.Reinstadler@gmail.com organization: Cardiology and Angiology, Medical University of Innsbruck, University Clinic of Internal Medicine III, Innsbruck, Austria |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/40080922$$D View this record in MEDLINE/PubMed |
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| Keywords | risk stratification IL WBCc IMH MVO CMR LVMM LV intramyocardial hemorrhage I/R NT-proBNP hs-cTnT inflammation MACE PCI STEMI ST-segment elevation myocardial infarction cardiac magnetic resonance hs-CRP major adverse cardiac events high-sensitivity C-reactive protein percutaneous coronary intervention high-sensitivity cardiac troponin T left ventricular interleukin white blood cell count microvascular obstruction ischemia-reperfusion left ventricular myocardial mass N-terminal pro-B-type natriuretic peptide |
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| Snippet | Ischemia-reperfusion (I/R) injury patterns detected by cardiac magnetic resonance imaging after percutaneous coronary intervention (PCI) have important... AbstractBackgroundIschemia-reperfusion (I/R) injury patterns detected by cardiac magnetic resonance imaging after percutaneous coronary intervention (PCI) have... |
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| StartPage | 101647 |
| SubjectTerms | cardiac magnetic resonance Cardiovascular inflammation intramyocardial hemorrhage Original Research risk stratification ST-segment elevation myocardial infarction |
| Title | Association of Intramyocardial Hemorrhage With Inflammatory Biomarkers in Patients With ST-Segment Elevation Myocardial Infarction |
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