Relationship of Plasma Neuropeptide Y with Angiographic, Electrocardiographic and Coronary Physiology Indices of Reperfusion During ST Elevation Myocardial Infarction

Overview

Journal Heart

Date 2013 Feb 14

PMID 23403409

Citations 31

Authors

Florim Cuculi

Neil Herring

Alberto R De Caterina

Adrian P Banning

Bernard D Prendergast

John C Forfar

Robin P Choudhury

Keith M Channon

Rajesh K Kharbanda

Affiliations

Soon will be listed here.

Abstract

Objectives: The co-transmitter neuropeptide Y (NPY) is released during high levels of sympathetic stimulation and is a potent vasoconstrictor. We defined the release profile of plasma NPY during acute ST elevation myocardial infarction, and tested the hypothesis that levels correlate with reperfusion measures after treatment with primary percutaneous coronary intervention (PPCI).

Design: Prospective observational study.

Setting: University hospital heart centre.

Patients: 64 patients (62.6±11.7 years-old, 73% male) presenting throughout the 24-h cycle of clinical activity with ST elevation myocardial infarction.

Interventions: PPCI.

Main Outcome Measures: NPY was measured (ELISA) in peripheral blood taken before and immediately after PPCI and at 6, 24 and 48 h post-PPCI. Reperfusion was assessed by angiographic criteria, ST segment resolution, invasive measurement of coronary flow reserve and the index of microcirculatory resistance.

Results: Plasma NPY levels were highest before PPCI (17.4 (8.8-42.2) pg/ml, median (IQR)) and dropped significantly post-PPCI (12.4 (6.5-26.7) pg/ml, p<0.0001) and after 6 h (9.0 (2.6-21.5) pg/ml, p=0.008). Patients with admission NPY levels above the median were significantly more hypertensive and tachycardic and were more likely to have diabetes mellitus. Patients with angiographic no-reflow (less than thrombolysis in myocardial infarction 3 flow and myocardial blush grade >2, n=16) or no electrocardiographic ST resolution (<70%, n=30) following PPCI had significantly higher plasma NPY levels. Patients with a coronary flow reserve <1.5 or index of microcirculatory resistance >33 also had significantly higher plasma NPY levels pre-PPCI and post-PPCI.

Conclusions: Plasma NPY levels correlate with indices of reperfusion and coronary microvascular resistance.

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