Coagulation factor XIII activity predicts left ventricular remodelling after acute myocardial infarction.

Abstract

AIMS:

Acute myocardial infarction (MI) is the major cause of chronic heart failure. The activity of blood coagulation factor XIII (FXIIIa) plays an important role in rodents as a healing factor after MI, whereas its role in healing and remodelling processes in humans remains unclear. We prospectively evaluated the relevance of FXIIIa after acute MI as a potential early prognostic marker for adequate healing.

METHODS AND RESULTS:

This monocentric prospective cohort study investigated cardiac remodelling in patients with ST-elevation MI and followed them up for 1 year. Serum FXIIIa was serially assessed during the first 9 days after MI and after 2, 6, and 12 months. Cardiac magnetic resonance imaging was performed within 4 days after MI (Scan 1), after 7 to 9 days (Scan 2), and after 12 months (Scan 3). The FXIII valine-to-leucine (V34L) single-nucleotide polymorphism rs5985 was genotyped. One hundred forty-six patients were investigated (mean age 58 ± 11 years, 13% women). Median FXIIIa was 118% (quartiles, 102-132%) and dropped to a trough on the second day after MI: 109% (98-109%; P < 0.001). FXIIIa recovered slowly over time, reaching the baseline level after 2 to 6 months and surpassed baseline levels only after 12 months: 124% (110-142%). The development of FXIIIa after MI was independent of the genotype. FXIIIa on Day 2 was strongly and inversely associated with the relative size of MI in Scan 1 (Spearman's ρ = -0.31; P = 0.01) and Scan 3 (ρ = -0.39; P < 0.01) and positively associated with left ventricular ejection fraction: ρ = 0.32 (P < 0.01) and ρ = 0.24 (P = 0.04), respectively.

CONCLUSIONS:

FXIII activity after MI is highly dynamic, exhibiting a significant decline in the early healing period, with reconstitution 6 months later. Depressed FXIIIa early after MI predicted a greater size of MI and lower left ventricular ejection fraction after 1 year. The clinical relevance of these findings awaits to be tested in a randomized trial.

• Authors: Anna Frey, Tobias Gassenmaier, Ulrich Hofmann, Dominik Schmitt, Georg Fette, Almuth Marx, Sabine Herterich, Valérie Boivin-Jahns, Georg Ertl, Thorsten Bley, Stefan Frantz, Roland Jahns, Stefan Störk
• Journal: ESC heart failure (ESC Heart Fail) Vol. 7 Issue 5 Pg. 2354-2364 (10 2020) ISSN: 2055-5822 [Electronic] England
• PMID: 32548915 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

Chemical References

• Factor XIII

Topics

• Factor XIII (genetics)
• Humans
• Myocardial Infarction (diagnosis)
• Prospective Studies
• Stroke Volume
• Ventricular Function, Left
• Ventricular Remodeling