AMERICAN JOURNAL OF CARDIOLOGY, vol.112, no.2, pp.187-193, 2013 (SCI-Expanded)
Although monocyte chemoattractant protein-1 (MCP-1) levels are increased in patients with
ST-segment elevation myocardial infarction, the prognostic value of MCP-1 in primary
percutaneous coronary intervention (pPCI) is not clear. The goal of the present study was to
investigate the association of MCP-1 levels with myocardial perfusion and prognosis in
patients with ST-segment elevation myocardial infarction undergoing pPCI. Consecutive
pPCI patients (n
[192) were assigned to tertiles according to their admission serum MCP-1
levels. Angiographic no-re
flow, Thrombolysis In Myocardial Infarction flow grade,
myocardial blush grade, and ST-segment resolution were assessed. Mortality and major
adverse cardiac events were evaluated during hospitalization and at the 3-year clinical followup
visit. Failure of ST resolution was associated with greater admissionMCP-1 levels. The risk
of no-re
flow (Thrombolysis In Myocardial Infarction flow £2 or Thrombolysis In Myocardial
Infarction
flow 3 with final myocardial blush grade £2 after pPCI and ST resolution <30%)
increased as the admission MCP-1 increased. The 3-year mortality increased as the MCP-1
level increased (8% vs 22% vs 28% for the 3 tertiles, p
<0.01). Multivariate logistic regression
analysis demonstrated thatMCP-1 levels at admission are a signi
ficant independent correlate
of 3-year mortality in patients with no-re
flow as detected by myocardial blush grade.
A receiver operating characteristics analysis identi
fied an optimum cut point of ‡254 pg/ml,
which was associated with a negative predictive value of 95% in association with 1-year
mortality. In conclusion, the plasmaMCP-1 levels at admission are independently associated
with the development of no-re
flow and 3-year mortality in patients with ST-segment elevation
myocardial infarction undergoing pPCI.