Prognostic differences of catestatin among young and elderly patients with acute myocardial infarction

doi:10.5847/wjem.j.1920-8642.2022.055

Abstract

Abstract:

BACKGROUND: Previous studies have reported inconsistent findings regarding the association between catestatin and outcomes of acute myocardial infarction (AMI). This study aims to investigate the prognostic value of catestatin for long-term outcomes in patients with AMI.

METHODS: One hundred and sixty-five patients with AMI were enrolled in this series. The plasma catestatin levels at baseline and clinical data were collected. All patients were followed up for four years to investigate whether there were major adverse cardiovascular events (MACEs), including cardiovascular death, recurrent AMI, rehospitalization for heart failure, and revascularization.

RESULTS: There were 24 patients who had MACEs during the follow-up period. The MACEs group had significantly lower plasma catestatin levels (0.74±0.49 ng/mL vs. 1.10±0.79 ng/mL, P=0.033) and were older (59.0±11.4 years old vs. 53.2±12.8 years old, P=0.036). The rate of MACEs was significantly higher in the elderly group (≥60 years old) than in the young group (<60 years old) (23.8% [15/63] vs. 8.8% [9/102], P=0.008). The catestatin level was significantly lower in the MACEs group than that in the non-MACEs group (0.76±0.50 ng/mL vs. 1.31±0.77 ng/mL, P=0.012), and catestatin was significantly associated with MACEs (Kaplan Meier, P=0.007) among the elderly group, but not in the young group (Kaplan Meier, P=0.893). In the Cox proportional hazards regression, high catestatin was one of the independent factors for predicting MACEs after adjustment for other risk factors (hazard ratio 0.19, 95% confidence interval 0.06-0.62, P=0.006) among elderly patients.

CONCLUSIONS: Elderly AMI patients with lower plasma catestatin levels are more likely to develop MACEs. Catestatin may be a novel marker for the long-term prognosis of AMI, especially in elderly patients.

Key words: Catestatin, Acute myocardial infarction, Elderly, Outcome

Wei-xian Xu, Yuan-yuan Fan, Yao Song, Xin Liu, Hui Liu, Li-jun Guo. Prognostic differences of catestatin among young and elderly patients with acute myocardial infarction[J]. World Journal of Emergency Medicine, 2022, 13(3): 169-174.

Figures/Tables 4

Table 1.

Figure 1.

Table 2.

Table 3.

References 31

1	Mahata SK, Mahata M, Fung MM, O'Connor DT. Catestatin: a multifunctional peptide from chromogranin A. Regul Pept. 2010; 162(1-3):33-43. doi: 10.1016/j.regpep.2010.01.006
2	Watanabe T. The emerging roles of chromogranins and derived polypeptides in atherosclerosis, diabetes, and coronary heart disease. Int J Mol Sci. 2021; 22(11): 6118. doi: 10.3390/ijms22116118
3	Mahata SK, Kiranmayi M, Mahapatra NR. Catestatin: a master regulator of cardiovascular functions. Curr Med Chem. 2018; 25(11):1352-74. doi: 10.2174/0929867324666170425100416
4	Zhao YL, Zhu D. Potential applications of catestatin in cardiovascular diseases. Biomark Med. 2016; 10(8):877-88. doi: 10.2217/bmm-2016-0086
5	Simunovic M, Supe-Domic D, Karin Z, Degoricija M, Paradzik M, Bozic J, et al. Serum catestatin concentrations are decreased in obese children and adolescents. Pediatr Diabetes. 2019; 20(5):549-55. doi: 10.1111/pedi.12825 pmid: 30714297
6	Bourebaba Y, Mularczyk M, Marycz K, Bourebaba L. Catestatin peptide of chromogranin A as a potential new target for several risk factors management in the course of metabolic syndrome. Biomedecine Pharmacother. 2021; 134:111113.
7	Liu L, Ding WH, Li RX, Ye XJ, Zhao J, Jiang J, et al. Plasma levels and diagnostic value of catestatin in patients with heart failure. Peptides. 2013; 46:20-5. doi: 10.1016/j.peptides.2013.05.003
8	Borovac JA, Glavas D, Susilovic Grabovac Z, Supe Domic D, Stanisic L, D'Amario D, et al. Circulating sST2 and catestatin levels in patients with acute worsening of heart failure: a report from the CATSTAT-HF study. ESC Heart Fail. 2020; 7(5):2818-28.
9	Borovac JA, Glavas D, Susilovic Grabovac Z, Supe Domic D, D'Amario D, Bozic J. Catestatin in acutely decompensated heart failure patients: insights from the CATSTAT-HF study. J Clin Med. 2019; 8(8):E1132.
10	Tota B, Gentile S, Pasqua T, Bassino E, Koshimizu H, Cawley NX, et al. The novel chromogranin A-derived serpinin and pyroglutaminated serpinin peptides are positive cardiac β-adrenergic-like inotropes. FASEB J. 2012; 26(7):2888-98. doi: 10.1096/fj.11-201111
11	Lu L, Wang YN, Li MC, Wang HB, Pu LJ, Niu WQ, et al. Reduced serum levels of vasostatin-2, an anti-inflammatory peptide derived from chromogranin A, are associated with the presence and severity of coronary artery disease. Eur Heart J. 2012; 33(18):2297-306. doi: 10.1093/eurheartj/ehs122
12	Pei ZQ, Ma DF, Ji L, Zhang J, Su JS, Xue WZ, et al. Usefulness of catestatin to predict malignant arrhythmia in patients with acute myocardial infarction. Peptides. 2014; 55:131-5. doi: 10.1016/j.peptides.2014.02.016
13	Zhu D, Xie H, Wang XY, Liang Y, Yu HY, Gao W. Correlation of plasma catestatin level and the prognosis of patients with acute myocardial infarction. PLoS One. 2015; 10(4):e0122993. doi: 10.1371/journal.pone.0122993
14	Zhu D, Xie H, Wang XY, Liang Y, Yu HY, Gao W. Catestatin-A novel predictor of left ventricular remodeling after acute myocardial infarction. Sci Rep. 2017; 7:44168. doi: 10.1038/srep44168
15	Xu WX, Yu HY, Wu HB, Li SH, Chen BX, Gao W. Plasma catestatin in patients with acute coronary syndrome. Cardiology. 2017; 136(3):164-9. doi: 10.1159/000448987
16	Kojima M, Ozawa N, Mori Y, Takahashi Y, Watanabe-Kominato K, Shirai R, et al. Catestatin prevents macrophage-driven atherosclerosis but not arterial injury-induced neointimal hyperplasia. Thromb Haemost. 2018; 118(1):182-94. doi: 10.1160/TH17-05-0349
17	Chen YJ, Wang XQ, Yang CD, Su XX, Yang WB, Dai Y, et al. Decreased circulating catestatin levels are associated with coronary artery disease: the emerging anti-inflammatory role. Atherosclerosis. 2019; 281:78-88. doi: 10.1016/j.atherosclerosis.2018.12.025
18	Kojima M, Ozawa N, Mori Y, Takahashi Y, Watanabe-Kominato K, Shirai R, et al. Catestatin prevents macrophage-driven atherosclerosis but not arterial injury-induced neointimal hyperplasia. Thromb Haemost. 2018; 118(1):182-94. doi: 10.1160/TH17-05-0349
19	Sato Y, Watanabe R, Uchiyama N, Ozawa N, Takahashi Y, Shirai R, et al. Inhibitory effects of vasostatin-1 against atherogenesis. Clin Sci (Lond). 2018; 132(23): 2493-507. doi: 10.1042/CS20180451
20	Chu SY, Peng F, Wang J, Liu L, Meng L, Zhao J, et al. Catestatin in defense of oxidative-stress-induced apoptosis: a novel mechanism by activating the beta 2 adrenergic receptor and PKB/Akt pathway in ischemic-reperfused myocardium. Peptides. 2020; 123:170200. doi: 10.1016/j.peptides.2019.170200
21	Task Force on the management of ST-segment elevation acute myocardial infarction, van de Werf F, Bax J, Betriu A, Blomstrom-Lundqvist C, Crea F, et al. ESC guidelines on management of acute myocardial infarction in patients presenting with persistent ST-segment elevation. Rev Esp Cardiol. 2009; 62(3):293, e1-47.
22	Jneid H. The 2012 ACCF/AHA focused update of the unstable angina/non-ST-elevation myocardial infarction (UA/NSTEMI) guideline: a critical appraisal. Methodist Debakey Cardiovasc J. 2012; 8(3):26-30. doi: 10.14797/mdcj-8-3-26 pmid: 23227283
23	Goriki Y, Tanaka A, Nishihira K, Kuriyama N, Shibata Y, Node K. A novel prediction model of acute kidney injury based on combined blood variables in STEMI. JACC: Asia. 2021; 1(3):372-81. doi: 10.1016/j.jacasi.2021.07.013
24	Wołowiec Ł, Rogowicz D, Banach J, Gilewski W, Sinkiewicz W, Grześk G. Catestatin as a new prognostic marker in stable patients with heart failure with reduced ejection fraction in two-year follow-up. Dis Markers. 2020; 2020:8847211.
25	Fornero S, Bassino E, Gallo MP, Ramella R, Levi R, Alloatti G. Endothelium dependent cardiovascular effects of the chromogranin A-derived peptides vasostatin-1 and catestatin. Curr Med Chem. 2012; 19(24):4059-67. pmid: 22834796
26	Fung MM, Salem RM, Mehtani P, Thomas B, Lu CF, Perez B, et al. Direct vasoactive effects of the chromogranin A (CgA) peptide catestatin in humans in vivo. Clin Exp Hypertens. 2010; 32(5):278-87. doi: 10.3109/10641960903265246
27	Filice E, Pasqua T, Quintieri AM, Cantafio P, Scavello F, Amodio N, et al. Chromofungin, CgA47-66-derived peptide, produces basal cardiac effects and postconditioning cardioprotective action during ischemia/reperfusion injury. Peptides. 2015; 71:40-8. doi: 10.1016/j.peptides.2015.06.013
28	Bassino E, Fornero S, Gallo MP, Gallina C, Femminò S, Levi R, et al. Catestatin exerts direct protective effects on rat cardiomyocytes undergoing ischemia/reperfusion by stimulating PI3K-Akt-GSK3β pathway and preserving mitochondrial membrane potential. PLoS One. 2015; 10(3):e0119790. doi: 10.1371/journal.pone.0119790
29	Muntjewerff EM, Dunkel G, Nicolasen MJT, Mahata SK, van den Bogaart G. Catestatin as a target for treatment of inflammatory diseases. Front Immunol. 2018; 9:2199. doi: 10.3389/fimmu.2018.02199 pmid: 30337922
30	Theurl M, Schgoer W, Albrecht K, Jeschke J, Egger M, Beer AGE, et al. The neuropeptide catestatin acts as a novel angiogenic cytokine via a basic fibroblast growth factor-dependent mechanism. Circ Res. 2010; 107(11):1326-35. doi: 10.1161/CIRCRESAHA.110.219493
31	Xu WX, Yu HY, Li WH, Gao W, Guo LJ, Wang GS. Plasma catestatin: a useful biomarker for coronary collateral development with chronic myocardial ischemia. PLoS One. 2016; 11(6):e0149062. doi: 10.1371/journal.pone.0149062

Variables	Young patients (<60 years old)
Variables	Non-MACE (n=93)	MACE (n=9)	P	Non-MACE (n=48)	MACE (n=15)	P
Male	79 (84.9)	7 (77.8)	0.572	28 (58.3)	11 (73.3)	0.296
Hypertension	54 (58.1)	7 (77.8)	0.249	41 (85.4)	9 (60.0)	0.034
Dyslipidemia	57 (61.3)	5 (55.6)	0.737	26 (54.2)	10 (66.7)	0.393
DM	27 (29.0)	3 (33.3)	0.787	15 (31.3)	3 (20.2)	0.400
Smoke	62 (66.7)	6 (66.7)	0.990	23 (47.9)	9 (60.0)	0.330
BMI, kg/m²	26.4±2.6	26.1±3.4	0.802	25.8±3.9	27.1±2.8	0.346
Age, years old	45.4±7.1	46.2±5.8	0.745	68.1±6.5	66.7±6.3	0.484
WBC, ×10⁹/L	8.73±3.32	9.52±2.93	0.517	6.72±2.69	8.07±2.88	0.149
HB, g/L	145.45±13.74	131.63±17.33	0.009^*	130.61±14.07	161.00±74.46	0.017^*
PLT, ×10⁹/L	217.76±47.02	210.75±77.17	0.707	182.24±70.31	205.31±57.50	0.307
UA, μmol/L	366.24±171.85	325.38±96.28	0.511	340.19±89.81	356.21±67.89	0.550
TCHO, mmol/L	4.66±1.17	4.76±0.98	0.800	4.33±0.96	4.77±0.88	0.146
TG, mmol/L	2.29±1.44	2.12±1.02	0.733	1.90±2.15	2.08±0.96	0.762
HDL-C, mmol/L	0.93±0.21	0.93±0.18	0.997	1.04±0.25	0.94±0.28	0.203
LDL-C, mmol/L	2.95±1.12	2.96±0.86	0.964	2.53±0.72	2.96±0.62	0.050
GLU, mmol/L	5.97±2.42	6.31±2.67	0.702	5.20±0.83	5.82±2.44	0.238
HBA1C, %	6.52±1.46	7.13±1.96	0.342	6.38±1.22	6.24±1.02	0.768
LVEF, %	64.56±10.58	53.67±10.27	0.004^*	65.44±11.29	62.33±11.15	0.358
Cr, μmol/L	86.21±18.80	76.56±17.40	0.142	84.94±15.92	92.67±21.04	0.135
CK-MB, U/L	58.52±19.67	153.25±75.63	0.014^*	56.28±19.52	50.85±14.66	0.879
NT-proBNP, pg/mL	890.36±117.88	1309.29±440.22	0.552	1302.17±511.18	513.70±325.02	0.642
Catestatin, ng/mL	0.98±0.78	0.69±0.49	0.275	1.31±0.77	0.76±0.50	0.012^*

Variables	ꞵ	HR	95%CI	P
Gender	-0.190	0.83	0.23-3.01	0.774
Hypertension	-0.822	0.44	0.15-1.33	0.146
Dyslipidemia	0.659	1.93	0.60-6.28	0.273
DM	-0.949	0.39	0.10-1.57	0.184
Smoke	0.446	1.56	0.49-5.01	0.454
LVEF	-0.025	0.98	0.93-1.03	0.351
Catestatin	-1.655	0.19	0.06-0.62	0.006^*

Variables	ꞵ	HR	95%CI	P
Gender	0.851	2.34	0.26-21.44	0.451
Hypertension	0.918	2.50	0.50-12.65	0.267
Dyslipidemia	-0.342	0.71	0.16-3.17	0.654
DM	-0.590	0.55	0.11-2.82	0.477
Smoke	0.382	1.47	0.23-9.55	0.690
LVEF	-0.075	0.93	0.88-0.98	0.004^*
Catestatin	-0.366	0.69	0.15-3.30	0.645

[1]	Guang-mei Wang, Yong Li, Shuo Wu, Wen Zheng, Jing-jing Ma, Feng Xu, Jia-qi Zheng, He Zhang, Jia-li Wang, Yu-guo Chen. The combination of creatine kinase-myocardial band isoenzyme and point-of-care cardiac troponin/ contemporary cardiac troponin for the early diagnosis of acute myocardial infarction [J]. World Journal of Emergency Medicine, 2022, 13(3): 163-168.
[2]	Qian-lin Gu, Peng Jiang, Hui-fen Ruan, Hao Tang, Yang-bing Liang, Zhong-fu Ma, Hong Zhan. The expression of oxidative stress genes related to myocardial ischemia reperfusion injury in patients with ST-elevation myocardial infarction [J]. World Journal of Emergency Medicine, 2022, 13(2): 106-113.
[3]	Yong Liang, Hong Zeng, Yu-geng Liu, Ai-min Xu, Wen-hong Liu. Prevalence of post-traumatic stress disorder after earthquakes among the elderly in China: A meta-analysis [J]. World Journal of Emergency Medicine, 2021, 12(2): 137-142.
[4]	Guo-xiong Chen, Hong-na Wang, Jin-lin Zou, Xiao-xu Yuan. Effects of intracoronary injection of nicorandil and tirofiban on myocardial perfusion and short-term prognosis in elderly patients with acute ST-segment elevation myocardial infarction after emergency PCI [J]. World Journal of Emergency Medicine, 2020, 11(3): 157-163.
[5]	Rakesh Gupta, Isaac Siemens, Sam Campbell. The use of outcome feedback by emergency medicine physicians: Results of a physician survey [J]. World Journal of Emergency Medicine, 2019, 10(1): 14-18.
[6]	Hai-jun Wang, Yong Gao, Shi-ning Qu, Chu-lin Huang, Hao Zhang, Hao Wang, Quan-hui Yang, Xue-zhong Xing. Preventable readmission to intensive care unit in critically ill cancer patients [J]. World Journal of Emergency Medicine, 2018, 9(3): 211-215.
[7]	Saeed Mahmood, Omaima Mahmood, Ayman El-Menyar, Mohammad Asim, Hassan Al-Thani. Predisposing factors, clinical assessment, management and outcomes of agitation in the trauma intensive care unit [J]. World Journal of Emergency Medicine, 2018, 9(2): 105-112.
[8]	Yuzeng Shen, Yee Chien Tay, Edward Wee Kwan Teo, Nan Liu, Shao Wei Lam, Marcus Eng Hock Ong. Association between the elderly frequent attender to the emergency department and 30-day mortality: A retrospective study over 10 years [J]. World Journal of Emergency Medicine, 2018, 9(1): 20-25.
[9]	Gan-nan Wang, Xu-feng Chen, Li Qiao, Yong Mei, Jin-ru Lv, Xi-hua Huang, Bin Shen, Jin-song Zhang. Comparison of extracorporeal and conventional cardiopulmonary resuscitation: A meta-analysis of 2 260 patients with cardiac arrest [J]. World Journal of Emergency Medicine, 2017, 8(1): 5-11.
[10]	Tigist Endale, Netsanet Fentahun, Desta Gemada, Mamusha Aman Hussen. Maternal and fetal outcomes in term premature rupture of membrane [J]. World Journal of Emergency Medicine, 2016, 7(2): 147-152.
[11]	Wai Lam Yip, Kit Ling Fan, Chun Tat Lui, Ling Pong Leung, Fu Ng, Kwok Leung Tsui. Utilization of the Accident & Emergency Departments by Chinese elderly in Hong Kong [J]. World Journal of Emergency Medicine, 2015, 6(4): 283-288.
[12]	Li-ming Li, Wen-bo Cai, Qin Ye, Jian-min Liu, Xin Li, Xiao-xing Liao. Comparison of plasma microRNA-1 and cardiac troponin T in early diagnosis of patients with acute myocardial infarction [J]. World Journal of Emergency Medicine, 2014, 5(3): 182-186.
[13]	Hua Zhou, Xiao-yan He, Shao-wei Zhuang, Juan Wang, Yan Lai, Wei-gang Qi, Yi-an Yao, Xue-bo Liu. Clinical and procedural predictors of no-reflow in patients with acute myocardial infarction after primary percutaneous coronary intervention [J]. World Journal of Emergency Medicine, 2014, 5(2): 96-102.
[14]	Le Onn Ho, Huihua Li, Nur Shahidah, Zhi Xiong Koh, Papia Sultana, Marcus Eng Hock Ong. Poor performance of the modified early warning score for predicting mortality in critically ill patients presenting to an emergency department [J]. World Journal of Emergency Medicine, 2013, 4(4): 273-278.
[15]	Li-li Ji, Xiao-feng Long, Hui Tian, Yu-fei Liu. Effect of transplantation of bone marrow stem cells on myocardial infarction size in a rabbit model [J]. World Journal of Emergency Medicine, 2013, 4(4): 304-310.