Evaluation of Coronary Flow Level with Mots-C in Patients with STEMI Undergoing Primary PCI.

Arquivos brasileiros de cardiologia2023PMID: 36629605

View on PubMed DOI: 10.36660/abc.20220358

Plain Language Summary

Clinical study of 52 STEMI patients and 42 controls comparing MOTS-c levels between STEMI patients who achieved normal coronary flow (TIMI 3) versus those with no-reflow (TIMI 0-2) after primary PCI, finding that patients with no-reflow had significantly lower MOTS-c levels, identifying MOTS-c deficiency as a potential contributor to microvascular obstruction in STEMI. First clinical evaluation of MOTS-c in coronary no-reflow. Establishes an association between MOTS-c deficiency and coronary no-reflow in STEMI—a potentially life-threatening complication of primary PCI where microvascular dysfunction prevents myocardial reperfusion despite coronary artery patency, suggesting MOTS-c measurement or supplementation as a potential approach to reducing no-reflow incidence.

Abstract

BACKGROUND: The protective effects of mitochondrial open reading frame of the 12S rRNA-c (MOTS-C) on cardiovascular diseases have been shown in numerous studies. However, there is little documentation of the relationship between MOTS-C and coronary blood flow in ST-segment elevation myocardial infarction (STEMI). OBJECTIVE: We aimed to investigate the role of MOTS-C, which is known to have cytoprotective properties in the pathogenesis of the no-reflow phenomenon, by comparing the coronary flow rate and MOTS-C levels in patients with STEMI submitted to primary PCI. METHODS: 52 patients with STEMI and 42 patients without stenosis >50% in the coronary arteries were included in the study. The STEMI group was divided into two groups according to post-PCI TIMI (Thrombolysis In Myocardial Infarction) flow grade:(i) No-reflow: grade 0, 1, and 2 and (ii) grade 3(angiographic success). A p value of <0.05 was considered significant. RESULTS: MOTS-C levels were significantly lower in the STEMI group compared to the control group (91.9 ± 8.9 pg/mL vs. 171.8±12.5 pg/mL, p<0.001). In addition, the Receiver Operating Characteristics (ROC) curve analysis indicated that serum MOTS-C levels had a diagnostic value in predicting no-reflow (Area Under the ROC curve [AUC]:0.95, 95% CI:0.856-0.993, p<0.001). A MOTS-C ≥84.15 pg/mL measured at admission was shown to have 95.3% sensitivity and 88.9% specificity in predicting no-reflow. CONCLUSION: MOTS-C is a strong and independent predictor of no-reflow and in-hospital MACE in patients with STEMI. It was also noted that low MOTS-C levels may be an important prognostic marker of and may have a role in the pathogenesis of STEMI.

Authors

Çakmak, Tolga; Yaşar, Erdoğan; Çakmak, Esin; Tekin, Suat; Karakuş, Yasin; Türkoğlu, Caner; Yüksel, Furkan