558 (Po) Vegf As A Predictor Of Viable Myocardium After A First Q-Wave Ami

Conference: 
Author(s): 
S. Patsilinakos, V. Pantoulas, D. Antonatos, K. Sotirellos, V. Fotopoulos, A. Christou, D. Aliferis, N. Tsingas, S. Spanodimos, D. Tsingas
Cardiology Dept, .Konstadopoulio-Ag. Olga. Hospital, Athens, Greece
Text: 
BACKGROUND:
Vascular Endothelial Growth Factor (VEGF) is a specific mitogen for vascular endothelial cells and probably plays a significant role in the angiogenic process after an acute myocardial infarction (AMI). The aim of this study was to determine whether serum VEGF levels can predict myocardial viability after a Q-wave AMI.
METHODS:
We recruited 52 patients (39 men, mean age 57.2 ñ 13.3 years) with no previous history of coronary artery disease and with first-presentation Q-wave AMI who were given thrombolysis with 20 U of reteplase, within 6 hours from the onset of chest pain. Serum VEGF levels were measured (by ELISA method) at admission (prior to the start of thrombolysis) and 7 days later. All patients underwent, within the next 30 days and before any intervention, single photon emission tomography (SPECT, Tl-201) with redistribution and delayed re-injection (with 1 mCi of Tl-201) images. The patients were divided into two groups: group A included 17 patients with fixed perfusion defects that indicated scar (not viable) tissue, and group B included 35 patients with reversible defects.
RESULTS:
Serum VEGF levels at admission had no statistically significant difference between the two groups (87.2 ñ 31.2 vs 103.3 ñ 40.6 ng/ml, p=0.156). Serum VEGF levels at day 7 were lower in group A than in group B (112.4 ñ 46.5 vs 175.5 ñ 77.8 ng/ml, p=0.003) and the same stood for the elevation rate of VEGF levels (VEGF on day 7/VEGF on admission, 1.28 ñ 0.53 vs 1.79 ñ 0.62 ng/ml, p=0.004)
CONCLUSIONS:
VEGF levels at the 7th day after an AMI and the rate of their elevation (from the baseline levels on admission) may predict the presence of viable myocardium after an AMI. VEGF levels on admission cannot play such a role. These results may be explained by the unsuccess of thrombolysis or/and by an unsatisfactory response to acute inflammation, factors that could both lead to scar tissue.
Literature: 
558 (PO) VEGF AS A PREDICTOR OF VIABLE MYOCARDIUM AFTER A FIRST Q-WAVE AMI