MAIN RESULTS:

1. Osteoprotegerin has limited value as a risk marker following myocardial infarction.

2. Interleukin-8 might be a target for treatment aiming to reduce inflammation-related myocardial injury after STEMI.

THESIS DEFENCE:

Thesis: Inflammation in STEMI patients: Associations with myocardial injury, adverse remodelling and clinical outcomes
Candidate: Christian Shetelig
Time: January 23, 2020 at 13:15
Place: University of Oslo, Domus Academica: Gamle festsal
Link to university website

SUMMARY:

(1) Circulating levels of osteoprotegerin the day after PCI are related to infarct size four months later in patients with STEMI. Higher levels are also associated with worse left ventricular ejection fraction. Both associations remained statistically significant after adjustment for several confounders but not after further adjustment for troponin T and CRP levels.

The study also shows that osteoprotegerin levels increase significantly after heparin administation. This might explain the major part of the association between osteoprotegerin and infarct size. Thus, this inflammatory marker is not suited as a risk marker following STEMI. 272 patients were included in the study.

(2) High levels of interleukin-8 are strongly associated with large infarct sizes and adverse clinical outcome. 258 STEMI patients were included, and higher levels of interleukin-8 one day after PCI predicted clinical events and overall survival during the next year. Cardiac MRI four months after the heart attack also revealed larger infarct sizes and reduced left ventricular ejection fraction in patients with above median levels of interleukin-8 the day after the event. These associations were independent of other variables, including troponins.

REFERENCES:

(1) Shetelig, C., Limalanathan, S., Eritsland, J., Hoffmann, P., Seljeflot, I., Gran, J. M., Aukrust, P., Ueland, T.,. & Andersen, G. Ø. (2017). Osteoprotegerin levels in ST-elevation myocardial infarction: Temporal profile and association with myocardial injury and left ventricular function. PloS one, 12(3).

(2) Shetelig, C., Limalanathan, S., Hoffmann, P., Seljeflot, I., Gran, J. M., Eritsland, J., & Andersen, G. Ø. (2018). Association of IL-8 with infarct size and clinical outcomes in patients with STEMI. Journal of the American College of Cardiology, 72(2), 187-198.