ESC Heart Failure (Oct 2020)

Coagulation factor XIII activity predicts left ventricular remodelling after acute myocardial infarction

  • Anna Frey,
  • Tobias Gassenmaier,
  • Ulrich Hofmann,
  • Dominik Schmitt,
  • Georg Fette,
  • Almuth Marx,
  • Sabine Herterich,
  • Valérie Boivin‐Jahns,
  • Georg Ertl,
  • Thorsten Bley,
  • Stefan Frantz,
  • Roland Jahns,
  • Stefan Störk

DOI
https://doi.org/10.1002/ehf2.12774
Journal volume & issue
Vol. 7, no. 5
pp. 2354 – 2364

Abstract

Read online

Abstract Aims Acute myocardial infarction (MI) is the major cause of chronic heart failure. The activity of blood coagulation factor XIII (FXIIIa) plays an important role in rodents as a healing factor after MI, whereas its role in healing and remodelling processes in humans remains unclear. We prospectively evaluated the relevance of FXIIIa after acute MI as a potential early prognostic marker for adequate healing. Methods and results This monocentric prospective cohort study investigated cardiac remodelling in patients with ST‐elevation MI and followed them up for 1 year. Serum FXIIIa was serially assessed during the first 9 days after MI and after 2, 6, and 12 months. Cardiac magnetic resonance imaging was performed within 4 days after MI (Scan 1), after 7 to 9 days (Scan 2), and after 12 months (Scan 3). The FXIII valine‐to‐leucine (V34L) single‐nucleotide polymorphism rs5985 was genotyped. One hundred forty‐six patients were investigated (mean age 58 ± 11 years, 13% women). Median FXIIIa was 118% (quartiles, 102–132%) and dropped to a trough on the second day after MI: 109% (98–109%; P < 0.001). FXIIIa recovered slowly over time, reaching the baseline level after 2 to 6 months and surpassed baseline levels only after 12 months: 124% (110–142%). The development of FXIIIa after MI was independent of the genotype. FXIIIa on Day 2 was strongly and inversely associated with the relative size of MI in Scan 1 (Spearman's ρ = –0.31; P = 0.01) and Scan 3 (ρ = –0.39; P < 0.01) and positively associated with left ventricular ejection fraction: ρ = 0.32 (P < 0.01) and ρ = 0.24 (P = 0.04), respectively. Conclusions FXIII activity after MI is highly dynamic, exhibiting a significant decline in the early healing period, with reconstitution 6 months later. Depressed FXIIIa early after MI predicted a greater size of MI and lower left ventricular ejection fraction after 1 year. The clinical relevance of these findings awaits to be tested in a randomized trial.

Keywords