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This work was supported by Ministerio de Economia y Competitividad and Instituto de Salud Carlos III, Fondo Investigacion Sanitaria (grant numbers PI15/00531, SAF2015-66515-R and RTC-2015-4184-1), the European Regional Development Fund (ERDF) 'Una manera de hacer Europa', Fundacio La Marato TV3 (grant numbers 20153030 and 20153031), the Catalonian Society of Cardiology SCC_ROCHE2015_001 (SAP Code: DN040578) and Siemens Healthcare 11/425.

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Serum levels of Growth Arrest-Specific 6 protein and soluble AXL in patients with ST-segment elevation myocardial infarction.

Publicat a:European Heart Journal-Acute Cardiovascular Care. 8 (8): 708-716 - 2019-12-01 8(8), DOI: 10.1177/2048872617740833

Autors: Caldentey, Guillem; Garcia De Frutos, Pablo; Cristobal, Helena; Garabito, Manel; Berruezo, Antonio; Bosch, Xavier; San Antonio, Rodolfo; Flores-Umanzor, Eduardo; Perea, Rosario J; De Caralt, Teresa M; Rodriguez, Jany; Ortiz-Perez, Jose T

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Serum soluble AXL (sAXL) and its ligand, Growth Arrest-Specific 6 protein (GAS6), intervene in tissue repair processes. AXL is increased in end-stage heart failure, but the role of GAS6 and sAXL in ST-segment elevation myocardial infarction (STEMI) is unknown.To study the association of sAXL and GAS6 acutely and six months following STEMI with heart failure and left ventricular remodelling.GAS6 and sAXL were measured by enzyme-linked immunosorbent assay at one day, seven days and six months in 227 STEMI patients and 20 controls. Contrast-enhanced magnetic resonance was performed during admission and at six months to measure infarct size and left ventricular function.GAS6, but not sAXL, levels during admission were significantly lower in STEMI than in controls. AXL increased progressively over time ( p<0.01), while GAS6 increased only from day 7. GAS6 or sAXL did not correlate with brain natriuretic peptide or infarct size. However, patients with heart failure (Killip >1) had higher values of sAXL at day 1 (48.9±11.9 vs. 44.0±10.7 ng/ml; p<0.05) and at six months (63.3±15.4 vs. 55.9±13.7 ng/ml; p<0.05). GAS6 levels were not different among subjects with heart failure or left ventricular remodelling. By multivariate analysis including infarct size, Killip class and sAXL at seven days, only the last two were independent predictors of left ventricular remodelling (odds ratio 2.24 (95% confidence interval: 1.08-4.63) and odds ratio 1.04 (95% confidence interval: 1.00-1.08) respectively).sAXL levels increased following STEMI. Patients with heart failure and left ventricular remodelling have higher sAXL levels acutely and at six month follow-up. These findings suggest a potential role of the GAS6-AXL system in the pathophysiology of left ventricular remodelling following STEMI.

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