Factor XIII-A dynamics in acute myocardial infarction: a novel prognostic biomarker?

Donato Gemmati; Giulia Zeri; Elisa Orioli; Rosella Mari; Stefano Moratelli; Marco Vigliano; Jlenia Marchesini; Maria Elena Grossi; Alessandro Pecoraro; Antonio Cuneo; Roberto Ferrari; Mirko Pinotti; Luisa M. Serino; Lucia Ansani

doi:10.1160/TH14-11-0952

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2015; 114(01): 123-132
DOI: 10.1160/TH14-11-0952

Cellular Signalling and Proteolysis

Schattauer GmbH

Factor XIII-A dynamics in acute myocardial infarction: a novel prognostic biomarker?

Authors

Donato Gemmati

¹Centre of Haemostasis & Thrombosis, Haematology Section, Department of Medical Sciences, University-Hospital of S. Anna, Ferrara, Italy
Giulia Zeri

¹Centre of Haemostasis & Thrombosis, Haematology Section, Department of Medical Sciences, University-Hospital of S. Anna, Ferrara, Italy
Elisa Orioli

¹Centre of Haemostasis & Thrombosis, Haematology Section, Department of Medical Sciences, University-Hospital of S. Anna, Ferrara, Italy
Rosella Mari

¹Centre of Haemostasis & Thrombosis, Haematology Section, Department of Medical Sciences, University-Hospital of S. Anna, Ferrara, Italy
Stefano Moratelli

¹Centre of Haemostasis & Thrombosis, Haematology Section, Department of Medical Sciences, University-Hospital of S. Anna, Ferrara, Italy
Marco Vigliano

¹Centre of Haemostasis & Thrombosis, Haematology Section, Department of Medical Sciences, University-Hospital of S. Anna, Ferrara, Italy
Jlenia Marchesini

²Operative Unit of Cardiology, University-Hospital S. Anna, Ferrara, Italy
Maria Elena Grossi

²Operative Unit of Cardiology, University-Hospital S. Anna, Ferrara, Italy
Alessandro Pecoraro

²Operative Unit of Cardiology, University-Hospital S. Anna, Ferrara, Italy
Antonio Cuneo

¹Centre of Haemostasis & Thrombosis, Haematology Section, Department of Medical Sciences, University-Hospital of S. Anna, Ferrara, Italy
Roberto Ferrari

³Department of Cardiology and LTTA Centre, University Hospital of Ferrara and Maria Cecilia Hospital, GVM Care&Research, E.S: Health Science Foundation, Cotignola, Italy
Mirko Pinotti

⁴Department of Life Sciences and Biotechnology; University of Ferrara, Italy
Luisa M. Serino

¹Centre of Haemostasis & Thrombosis, Haematology Section, Department of Medical Sciences, University-Hospital of S. Anna, Ferrara, Italy
Lucia Ansani

²Operative Unit of Cardiology, University-Hospital S. Anna, Ferrara, Italy

Abstract

Summary

After acute myocardial infarction (MI) the damaged heart has to be repaired. Factor XIII (FXIII) is considered a key molecule in promoting heart healing. FXIII deficiency was associated to cardiac rupture and anomalous remodelling in MI. During MI, FXIII contributes firstly to the intracoronary thrombus formation and shortly after to heal the myocardial lesion. To quantify the real contribution of FXIII in this process, and to explore its possible prognostic role, we monitored the FXIII-A subunit levels in 350 acute MI patients during the first six days (d0-d5) plus a control at 30–60 days (d30). A one-year follow-up was performed for all the patients. A transient drop in the FXIII-A mean level was noted in the whole cohort of patients (FXIII-Ad0 99.48 ± 30.5 vs FXIII-Ad5 76.51 ± 27.02; p< 0.0001). Interestingly, those who developed post-MI heart failure showed the highest drop (FXIII-Ad5 52.1 ± 25.2) and they already presented with low levels at recruitment. Similarly, those who died showed the same FXIII-A dynamic (FXIII-Ad5 54.0 ± 22.5). Conversely, patients who remained free of major adverse cardiac events, had lower consuming (FXIII-Ad0 103.6 ± 29.1 vs FXIII-Ad5 84.4 ± 24.5; p< 0.0001). Interestingly, the FXIII-A drop was independent from the amount of injury assessed by TnT and CKMB levels. The survival analysis ascribed an increased probability of early death or heart failure inversely related to FXIII-A quartiles (FXIII-A25th< 59.5 %; hazard ratio 4.25; 2.2–5.1; p< 0.0001). Different FXIII-A dynamics and levels could be utilised as early prognostic indicators during acute MI, revealing the individual potential to heal and suggesting tailored treatments to avoid heart failure or its extreme consequence.

Note: This paper was presented in part at the 14^th Congress of the International Society on Thrombosis and Haemostasis, Amsterdam, Netherlands, June 29 – July 24, 2013.

Keywords

Factor XIII - myocardial infarction - myocardial healing - prognosis - myocardial infarction biomarkers

Full Text

References

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