Korean Circ J.  2012 Jul;42(7):464-470. 10.4070/kcj.2012.42.7.464.

Serial Plasma Levels of Angiogenic Factors in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

• Kim BH
• Ko YG
• Her AY
• Kim JS
• Hwang KC
• Shin DH
• Kim BK
• Choi D
• Ha JW
• Hong MK
• Jang Y

• KMID: 2094118
• DOI: http://doi.org/10.4070/kcj.2012.42.7.464

Abstract

BACKGROUND AND OBJECTIVES
Patients with acute myocardial infarction show varying degrees of collateral development. However, the relationships between angiogenic factors and degree of collaterals are not well known.
SUBJECTS AND METHODS
Fifty-nine patients (mean age, 59+/-10 years) with ST-segment elevation myocardial infarction (STEMI) underwent primary percutaneous coronary intervention (PCI). Patients were divided into one of 2 groups: group I (Rentrop collateral grade 0/1, n=34) or group II (grade 2/3, n=25). Plasma levels of vascular endothelial growth factor (VEGF), soluble VEGF receptor (sFlt-1), angiopoietin (Ang)-2, and soluble Tie-2 at baseline, 24 and 48 hours after PCI were measured.
RESULTS
There were fewer diabetic patients and higher incidence of previous angina and multi-vessel disease in group II. Group II had a lower left ventricular ejection fraction and a trend toward longer pain-to-balloon time. Plasma levels of Ang-2, sFlt-1 were elevated prior to primary PCI and decreased after PCI, whereas plasma level of VEGF was relatively low initially, however rose after PCI. sTie-2 levels showed no significant interval change in group I, but decreased over time in group II. VEGF, sFlt-1, and Tie-2 levels did not differ between the groups at each time point. However, plasma levels of Ang-2 were higher in group I than in group II at baseline and at 48 hours.
CONCLUSION
Presence of collaterals in STEMI patients undergoing primary PCI was associated with lesser rise in Ang-2 plasma level. VEGF showed a delayed response to acute ischemia compared to Ang-2. Clinical implications of our findings need to be investigated in further studies.

Keyword

Myocardial infarction; Angiogenesis modulating agents; Vascular endothelial growth factor; Angiopoietin-2

MeSH Terms

Angiogenesis Inducing Agents
Angiogenesis Modulating Agents
Angiopoietin-2
Humans
Incidence
Ischemia
Myocardial Infarction
Percutaneous Coronary Intervention
Plasma
Receptors, Vascular Endothelial Growth Factor
Stroke Volume
Vascular Endothelial Growth Factor A
Angiogenesis Inducing Agents
Angiogenesis Modulating Agents
Angiopoietin-2
Receptors, Vascular Endothelial Growth Factor
Vascular Endothelial Growth Factor A

Figure

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  Fig. 1 Plasma levels of VEGF (A), sFlt-1 (B), Ang-2 (C), and sTie-2 (D) at baseline in emergency room and at 24 and 48 hours after primary percutaneous coronary intervention. Group I (n=34): rentrop collateral circulation grade 0 or 1; group II (n=25): grade 2 or 3. VEGF: vascular endothelial growth factor, sFlt: soluble VEGF receptor, Ang-2: angiopoietin-2, ER: emergency room, PCI: percutaneous coronary intervention.

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