MYOCARDIAL ISCHEMIA AND INFARCTION RELATIONSHIP BETWEEN BIOMARKERS AND SUBSEQUENT MAJOR ADVERSE CARDIOVASCULAR EVENTS AFTER ST-ELEVATION MYOCARDIAL INFARCTION: A HORIZONS-AMI SUBSTUDY

Abstract Category: 3. Acute Myocardial Infarction—TherapySession-Poster Board Number: 1105-317Authors: Bernhard Witzenbichler, Gregg W. Stone, Bimmer E. Claessen, Bruce R. Brodie, Witold Ruzyllo, Giulio Guagliumi, Jochen Whrle, Kurt Huber, Janusz Kochman, Krzysztof Zmudka, Franz Hartmann, Irene Apostolidou, George Syros, Selene Leon, Roxana Mehran, George D. Dangas, Charit Campus Benjamin Franklin, Berlin, Germany, Columbia University Medical Center and the Cardiovascular Research Foundation, New York, NYBackground: Inlammatory and thrombotic biomarkers can help identify patients at high risk for subsequent major adverse cardiovascular events (MACE). However, their utility in patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI), especially with DES has not been evaluated.Methods: 23 inlammatory and thrombotic biomarkers were measured at enrollment and just prior to discharge in 502 STEMI patients enrolled in a formal substudy of the HORIZONS-AMI trial, and analyzed in a central core laboratory. All patients underwent primary PCI with TAXUS paclitaxel-eluting stents. We divided patients in tertiles based on biomarker levels and explored associations between biomarkers and MACE (composite of death, reinfarction, target vessel revascularization for ischemia, and stroke) up to 3 years follow-up. For biomarkers measured at discharge, only out-of hospital events were analyzed.Results: The 3-Year MACE rate was 17.6% (n=87). Brain natriuretic peptide (BNP), cystatin-C, d-dimer, measured at baseline, and adiponectin, angiotensinogen, and myeloperoxidase measured at discharge were predictive of 3-year MACE (Table 1). No association was found between hs-CRP and 3-year MACE. Multivariate analysis models will be available at time of presentation.Conclusion: BNP, cystatin-c, d-dimer, measured at enrollment, and adiponectin, angiotensinogen, and myeloperoxidase upon discharge may be associated with 3-year MACE after STEMI.