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.

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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

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