Biomarker profiles as descriptors of left ventricular remodeling after acute myocardial infarction

Background Biomarker expression can predict subsequent cardiovascular events. The goal of this study was to determine the pattern of expression in blood of a broad array of cytokines and growth factors taken 24-72 h after an ST elevation myocardial infarction (STEMI) involving the left anterior descending (LAD) coronary artery. Methods Blood was taken from 16 patients with LAD STEMI. Cytokine and growth factor expressions were quantified with the use of a Milliplex cytokine/chemokine array analysis that tested 42 analytes. Results from patients were compared with those in blood from 20 healthy volunteers. Results Most (15/16) participants had positive remodeling without reduction in left ventricular function during follow-up. Analytes were grouped based on their function into those that activate class 1 T-helper cells (Th1 activates cell-mediated immunity), those that activated a Th2 response (activates humoral immunity and attenuates cell-mediated immunity), chemokines (attract leukocytes), and growth factors (promote a healing response). Elevation of cytokines involved in the Th2 response predominated over the Th1 response demonstrating a balance favoring tolerance and limiting activation of cell-mediated immunity. The concentration of selected chemokines favoring cell-mediated immunity was not elevated. The concentration of selected growth factors was increased. Conclusion The cytokine expression, 24-72 h after an LAD STEMI, suggests that positive ventricular remodeling is associated with growth factor expression and limitation of cell-mediated immunity. Subsequent studies are warranted to determine whether deviation from this pattern identifies patients at an increased risk of adverse remodeling after myocardial infarction. Coron Artery Dis 22:311-316 (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.