Amyloid β1‐40 Predicts Long‐Term Mortality Rate in Patients With Acute Myocardial Infarction
Background Amyloid β1‐40 (Aβ1‐40) contributes to atherosclerosis, being involved in plaque formation and destabilization. The prognostic role of Aβ1‐40 in patients with acute myocardial infarction is currently limited to non–ST‐segment–elevation myocardial infarction (NSTEMI). We examined the progno...
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Wiley
2025-04-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.035620 |
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| author | Aneta Aleksova Alessandra Lucia Fluca Alessandro Pierri Giulia Barbati Antonio Paolo Beltrami Laura Padoan Enzo Merro Maria Marketou Donna Zwas Stefano D'Errico Gianfranco Sinagra Milijana Janjusevic |
| author_facet | Aneta Aleksova Alessandra Lucia Fluca Alessandro Pierri Giulia Barbati Antonio Paolo Beltrami Laura Padoan Enzo Merro Maria Marketou Donna Zwas Stefano D'Errico Gianfranco Sinagra Milijana Janjusevic |
| author_sort | Aneta Aleksova |
| collection | DOAJ |
| description | Background Amyloid β1‐40 (Aβ1‐40) contributes to atherosclerosis, being involved in plaque formation and destabilization. The prognostic role of Aβ1‐40 in patients with acute myocardial infarction is currently limited to non–ST‐segment–elevation myocardial infarction (NSTEMI). We examined the prognostic value of Aβ1‐40 in a real‐world cohort of patients with acute myocardial infarction (both ST‐segment–elevation myocardial infarction [STEMI] and NSTEMI) and identified predictors for its elevated levels. Methods and Results Our population included 1119 consecutive patients (mean age, 67 years; 72% men; and STEMI, 68%). The median Aβ1‐40 concentration on admission was 86.9 (interquartile range, 54.5–128.9) pg/mL, and there was no difference in Aβ1‐40 levels between NSTEMI and STEMI (P=0.1). Higher Aβ1‐40 levels were predicted by older age, lower left ventricular ejection fraction, glycated hemoglobin >39 mmol/mol and glomerular filtration rate <60 mL/min per m2. From the final multivariable model, a nomogram was computed to determine probability of high Aβ1‐40. During the median follow‐up of 57 months, 193 patients (17.2%) died. Kaplan–Meier analysis revealed higher mortality risk in patients with Aβ1‐40 levels above the median (P<0.01), consistent across STEMI (P<0.01) and NSTEMI (P=0.01) subgroups. At Cox multivariable analysis including the entire cohort, Aβ1‐40 levels were predictive of death (hazard ratio, 1.03; P=0.01), together with older age, higher high‐sensitivity C‐reactive protein levels, smoking, glomerular filtration rate <60 mL/min per m2, worse left ventricular ejection fraction, and previous ischemic events. In the STEMI subcohort, Aβ1‐40 remained a significant predictor, along with advanced age, worse left ventricular ejection fraction, smoking, and elevated high‐sensitivity C‐reactive protein. No such association was found in patients with NSTEMI (P=0.17), likely due to the smaller cohort size and low event rate. Conclusions Aβ1‐40 is an independent predictor of death and improves risk stratification in patients with acute myocardial infarction. |
| format | Article |
| id | doaj-art-34e2e6622a0f4b539e4722f3094aefff |
| institution | OA Journals |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-34e2e6622a0f4b539e4722f3094aefff2025-08-20T01:52:38ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-04-0114810.1161/JAHA.124.035620Amyloid β1‐40 Predicts Long‐Term Mortality Rate in Patients With Acute Myocardial InfarctionAneta Aleksova0Alessandra Lucia Fluca1Alessandro Pierri2Giulia Barbati3Antonio Paolo Beltrami4Laura Padoan5Enzo Merro6Maria Marketou7Donna Zwas8Stefano D'Errico9Gianfranco Sinagra10Milijana Janjusevic11Cardiothoracovascular Department Azienda Sanitaria Universitaria Giuliano Isontina Trieste ItalyCardiothoracovascular Department Azienda Sanitaria Universitaria Giuliano Isontina Trieste ItalyDepartment of Cardiology San Paolo Hospital Bari ItalyBiostatistics Unit, Department of Medical Surgical and Health Sciences University of Trieste ItalyDepartment of Medicine (DMED) Università degli Studi di Udine Udine ItalyCardiovascular Pathophysiology University of Perugia ItalyCardiothoracovascular Department Azienda Sanitaria Universitaria Giuliano Isontina Trieste ItalySchool of Medicine, Cardiology Department Heraklion University General Hospital, University of Crete GreeceLinda Joy Pollin Cardiovascular Wellness Center for Women Heart Institute, Hadassah University Medical Center Jerusalem IsraelDepartment of Medical Surgical and Health Sciences University of Trieste ItalyCardiothoracovascular Department Azienda Sanitaria Universitaria Giuliano Isontina Trieste ItalyCardiothoracovascular Department Azienda Sanitaria Universitaria Giuliano Isontina Trieste ItalyBackground Amyloid β1‐40 (Aβ1‐40) contributes to atherosclerosis, being involved in plaque formation and destabilization. The prognostic role of Aβ1‐40 in patients with acute myocardial infarction is currently limited to non–ST‐segment–elevation myocardial infarction (NSTEMI). We examined the prognostic value of Aβ1‐40 in a real‐world cohort of patients with acute myocardial infarction (both ST‐segment–elevation myocardial infarction [STEMI] and NSTEMI) and identified predictors for its elevated levels. Methods and Results Our population included 1119 consecutive patients (mean age, 67 years; 72% men; and STEMI, 68%). The median Aβ1‐40 concentration on admission was 86.9 (interquartile range, 54.5–128.9) pg/mL, and there was no difference in Aβ1‐40 levels between NSTEMI and STEMI (P=0.1). Higher Aβ1‐40 levels were predicted by older age, lower left ventricular ejection fraction, glycated hemoglobin >39 mmol/mol and glomerular filtration rate <60 mL/min per m2. From the final multivariable model, a nomogram was computed to determine probability of high Aβ1‐40. During the median follow‐up of 57 months, 193 patients (17.2%) died. Kaplan–Meier analysis revealed higher mortality risk in patients with Aβ1‐40 levels above the median (P<0.01), consistent across STEMI (P<0.01) and NSTEMI (P=0.01) subgroups. At Cox multivariable analysis including the entire cohort, Aβ1‐40 levels were predictive of death (hazard ratio, 1.03; P=0.01), together with older age, higher high‐sensitivity C‐reactive protein levels, smoking, glomerular filtration rate <60 mL/min per m2, worse left ventricular ejection fraction, and previous ischemic events. In the STEMI subcohort, Aβ1‐40 remained a significant predictor, along with advanced age, worse left ventricular ejection fraction, smoking, and elevated high‐sensitivity C‐reactive protein. No such association was found in patients with NSTEMI (P=0.17), likely due to the smaller cohort size and low event rate. Conclusions Aβ1‐40 is an independent predictor of death and improves risk stratification in patients with acute myocardial infarction.https://www.ahajournals.org/doi/10.1161/JAHA.124.035620acute myocardial infarctionamyloid β1‐40deathNSTEMIrisk stratificationSTEMI |
| spellingShingle | Aneta Aleksova Alessandra Lucia Fluca Alessandro Pierri Giulia Barbati Antonio Paolo Beltrami Laura Padoan Enzo Merro Maria Marketou Donna Zwas Stefano D'Errico Gianfranco Sinagra Milijana Janjusevic Amyloid β1‐40 Predicts Long‐Term Mortality Rate in Patients With Acute Myocardial Infarction Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease acute myocardial infarction amyloid β1‐40 death NSTEMI risk stratification STEMI |
| title | Amyloid β1‐40 Predicts Long‐Term Mortality Rate in Patients With Acute Myocardial Infarction |
| title_full | Amyloid β1‐40 Predicts Long‐Term Mortality Rate in Patients With Acute Myocardial Infarction |
| title_fullStr | Amyloid β1‐40 Predicts Long‐Term Mortality Rate in Patients With Acute Myocardial Infarction |
| title_full_unstemmed | Amyloid β1‐40 Predicts Long‐Term Mortality Rate in Patients With Acute Myocardial Infarction |
| title_short | Amyloid β1‐40 Predicts Long‐Term Mortality Rate in Patients With Acute Myocardial Infarction |
| title_sort | amyloid β1 40 predicts long term mortality rate in patients with acute myocardial infarction |
| topic | acute myocardial infarction amyloid β1‐40 death NSTEMI risk stratification STEMI |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.035620 |
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