The N-terminal propeptide of type III procollagen in patients with acute coronary syndrome: A link between left ventricular end-diastolic pressure and cardiovascular events

Cheng Hung Lee, Wen Chen Lee, Shang Hung Chang, Ming Shien Wen, Kuo Chun Hung

Research output: Contribution to journalJournal Article peer-review

7 Scopus citations

Abstract

Background: Despite the usefulness of N-terminal propeptide of type III procollagen (PIIINP) in detecting enhanced collagen turnover in patients with congestive heart failure, the value added by PIIINP to the use of clinical variables and echocardiography in relation to directly measured left ventricular (LV) enddiastolic pressure (EDP) and the outcome of acute coronary syndrome (ACS) has not been clearly defined. Methods and Results: This study involved 168 adult patients with ACS, who underwent echocardiography, measurement of serum PIIINP levels, and cardiac catheterization. Pulsed wave tissue Doppler imaging (PWTDI), which revealed mean peak systolic (s′), early (e′), and late diastolic (a′) velocities, was carried out and the eas index of LV function was evaluated: e′/(a′ x s′). The patients were divided into three study groups based on the degree of LVEDP - normal (<16 mmHg), intermediate (16-30 mmHg), and high (>30 mmHg) LVEDP. All patients were followed-up to determine cardiac-related death and revascularization. Patients with high LVEDP had significantly more PIIINP than those with intermediate or normal LVEDP (all post hoc p<0.05). The presence of coronary artery disease, the left atrial volume index (LAVI), the ratio of transmitral early and late diastolic flow velocities, a′, and the eas index were significantly correlated with LVEDP. According to multiple stepwise analysis, PIIINP, LAVI and the eas index were the three independent predictors of the level of LVEDP (PIIINP, p < 0.001; LAVI, p=0.007; eas index, p=0.021). During follow-up (median, 24 months), 32 participants suffered from cardiac events, PIIINP and LAVI were significant predictors of cardiac mortality and hospitalization (PIIINP, hazard ratio (HR) 2.589, p=0.002; LAVI, HR 1.040, p=0.027). Conclusions: PIIINP is a highly effective means to evaluate LVEDP in patients with ACS. The PIIINP is also correlated with cardiac mortality and revascularization, providing an additional means of evaluating and managing patients with ACS.

Original languageEnglish
Article numbere114097
JournalPLoS ONE
Volume10
Issue number1
DOIs
StatePublished - 05 01 2015

Bibliographical note

Publisher Copyright:
© 2015 Lee et al.

Fingerprint

Dive into the research topics of 'The N-terminal propeptide of type III procollagen in patients with acute coronary syndrome: A link between left ventricular end-diastolic pressure and cardiovascular events'. Together they form a unique fingerprint.

Cite this