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Serial Plasma Levels of Angiogenic Factors in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

  • Kim, Bo-Hyun (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System) ;
  • Ko, Young-Guk (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System) ;
  • Her, Ae-Young (Division of Cardiology, Kangwon National University Hospital) ;
  • Kim, Jung-Sun (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System) ;
  • Hwang, Ki-Chul (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System) ;
  • Shin, Dong-Ho (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System) ;
  • Kim, Byeong-Keuk (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System) ;
  • Choi, Dong-Hoon (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System) ;
  • Ha, Jong-Won (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System) ;
  • Hong, Myeong-Ki (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System) ;
  • Jang, Yang-Soo (Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System)
  • Published : 2012.07.31

Abstract

Background and Objectives: Patients with acute myocardial infarction show varying degrees of collateral development. However, the relationships between angiogenic factors and degree of collaterals are not well known. Subjects and Methods: Fifty-nine patients (mean age, 59${\pm}$10 years) with ST-segment elevation myocardial infarction (STEMI) underwent primary percutaneous coronary intervention (PCI). Patients were divided into one of 2 groups: group I (Rentrop collateral grade 0/1, n=34) or group II (grade 2/3, n=25). Plasma levels of vascular endothelial growth factor (VEGF), soluble VEGF receptor (sFlt-1), angiopoietin (Ang)-2, and soluble Tie-2 at baseline, 24 and 48 hours after PCI were measured. Results: There were fewer diabetic patients and higher incidence of previous angina and multi-vessel disease in group II. Group II had a lower left ventricular ejection fraction and a trend toward longer pain-to-balloon time. Plasma levels of Ang-2, sFlt-1 were elevated prior to primary PCI and decreased after PCI, whereas plasma level of VEGF was relatively low initially, however rose after PCI. sTie-2 levels showed no significant interval change in group I, but decreased over time in group II. VEGF, sFlt-1, and Tie-2 levels did not differ between the groups at each time point. However, plasma levels of Ang-2 were higher in group I than in group II at baseline and at 48 hours. Conclusion: Presence of collaterals in STEMI patients undergoing primary PCI was associated with lesser rise in Ang-2 plasma level. VEGF showed a delayed response to acute ischemia compared to Ang-2. Clinical implications of our findings need to be investigated in further studies.

Keywords

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