Association of serum periostin with cardiac function and short-term prognosis in acute myocardial infarction patients

Abstract

Background: Periostin was proved to play an important role in extra-cellular matrix remodeling after acute myocardial infarction (AMI). Myocardial periostin was markedly up-regulated after AMI and participated in the maladaptive process of cardiac remodeling. However, few researches focused on the circulating periostin and its significance. This study aims to investigate the association of serum periostin level with cardiac function and short-term prognosis in AMI patients.

Methodology/principal findings: We totally recruited 50 patients diagnosed as ST-elevation myocardial infarction. Blood samples were taken within 12 hours after the onset of AMI before emergency coronary revascularization procedures. Serum periostin was measured using enzyme-linked immunosorbent assay. All patients received echocardiography examination within one week after hospitalization. Correlations of serum periostin with echocardiography parameters, Killip class and myocardium injury biomarkers (CK-MB/troponin T) were investigated. AMI patients were divided into two groups by serum periostin level (higher/lower periostin group) and followed up for six months. Primary endpoints included cardiovascular mortality, nonfatal stroke/transient ischemic attack, chest pain occurrence and re-hospitalization. Secondary endpoint referred to composite cardiovascular events including all the primary endpoints.

Result: Serum periostin was in negative association with left ventricular ejection fraction (LVEF) (r = -0.472, *p<0.01) and left atrium diameter (LAD) (r = -0.328, *p<0.05). Positive correlation was found between serum periostin level and Killip class (r = 0.395, *p<0.01). There was no association between serum periostin and CK-MB or troponin T (p>0.05). After six months follow up, patients in higher periostin group showed increased composite cardiovascular events (*p<0.05). Patients showed no significant difference in primary endpoints between the two groups.

Conclusions/significance: Serum periostin was in negative correlation with LVEF and LAD, in positive association with Killip class and higher serum periostin level may be predictive for worse short-term disease prognosis indicated as more composite cardiovascular events six months post AMI.

Figure 1. Association of periostin level with echocardiography parameters and Killip class.

(A) Serum periostin level was in negative correlation with left ventricle ejection fraction in AMI patients (r = −0.472, p<0.01). (B) Serum periostin level was in negative correlation with left atrium diameter in AMI patients (r = −0.328, p<0.05). (C) Serum periostin level was in positive correlation with Killip class in AMI patients (r = 0.395, p<0.01).

Figure 2. Serum periostin showed no correlation with myocardium injury biomarkers CK-MB (A) (r = 0.191, p>0.05) or Troponin T (B) (r = 0.192, p>0.05) in AMI patients.

Figure 3. Effect of serum periostin on cardiovascular outcomes six months post AMI.