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. 2019 Jan;42(1):32-38.
doi: 10.1002/clc.23090. Epub 2018 Dec 10.

Neprilysin levels at the acute phase of ST-elevation myocardial infarction

Hugo Bernelin  1 , Nathan Mewton  2   3 , Salim Si-Mohamed  4   5 , Pierre Croisille  6   7 , Gilles Rioufol  8   9 , Eric Bonnefoy-Cudraz  1   9 , Philippe Douek  4   5 , Nathalie Dufay  10 , Camille Amaz  3 , Claire Jossan  3 , Michel Ovize  2   3   9 , Thomas Bochaton  1   9
Affiliations

Neprilysin levels at the acute phase of ST-elevation myocardial infarction

Hugo Bernelin et al. Clin Cardiol. 2019 Jan.

Abstract

Background: Several preliminary analyses suggested an association between neprilysin (NEP) levels and myocardial infarction.

Hypothesis: The objective was to assess whether NEP plasma levels following reperfusion might be a surrogate for infarct size (IS) or predict adverse outcomes in acute ST-segment elevation myocardial infarction (STEMI) patients.

Methods: We measured NEP levels in a prospective cohort of 203 patients with STEMI referred for primary percutaneous coronary intervention. Circulating soluble NEP was measured by enzyme-linked immunosorbent assay at admission (t0) and 4 hours later (t4) following reperfusion and on 7 times points (t0, t4, t12, t24, t48, day 7 and day 30) in a subset of 21 patients. IS and left ventricular ejection fraction (LVEF) were measured at 1 month by cardiac magnetic resonance. Adverse cardiovascular outcomes were collected at 12-month follow-up.

Results: Median t0 and t4 NEP levels in 203 patients were respectively 88.3 pg/mL (interquartile range [IQR] [14; 375.4]) and 101.5 pg/mL (IQR [18.5; 423.8]). These levels remained unchanged over 1 month (P = 0.70). NEP levels did not correlate significantly with IS (P = 0.51) or LVEF (P = 0.34). There was no correlation between NEP and troponin, creatine kinase and interleukin-6 levels at h0 and h4. NEP levels above the median were not associated with adverse outcomes at follow-up (hazard ratio = 1.28, 95% confidence interval [0.69; 2.37]; P = 0.42).

Conclusions: NEP serum levels were widely distributed and did not change significantly in the first hours and 1-month period following reperfusion in STEMI patients. There was no significant relationship with markers of infarct size and inflammation, and 1-year adverse outcomes.

Keywords: CMR; STEMI; interleukine-6; neprilysin.

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Conflict of interest statement

The authors declare no potential conflict of interests.

Figures

Figure 1
Figure 1
Neprilysin levels and distributions at t0 and t4. There was no significant variation and a wild distribution of neprilysin between admission and 4 hours later
Figure 2
Figure 2
Kaplan‐Meier curves for the composite outcome of death from any cause, myocardial infarction or hospitalization for cardiovascular cause according to t0 neprilysin (NEP) levels. There was no relationship between NEP level and adverse cardiovascular events: hazard ratio = 1.28, 95% confidence interval [0.69; 2.37]; P = 0.42
See this image and copyright information in PMC

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