Prognostic Value of Corin in Acute Myocardial Infarction

Study Questions:

What is the prognostic value of plasma soluble corin in patients with acute myocardial infarction (AMI)?

Methods:

The investigators enrolled 1,382 consecutive AMI patients in a prospective cohort study and explored the association of plasma corin with AMI outcomes using multivariable Cox proportional hazards analysis. Demographical, clinical, and biochemical data were obtained from the medical records. All patients received standard medical treatment, and written informed consent was obtained from each participant. A subgroup analysis was undertaken to determine whether corin was a significant predictor for major adverse cardiac events (MACE) in both ST-elevation myocardial infarction (STEMI) and non–STEMI patients (interaction term was found to be significant). A two-tailed p value <0.05 was considered statistically significant in this study.

Results:

Patients with low corin levels were more likely to be female and to have histories of hypertension and heart failure (HF). The Kaplan-Meier survival curves indicated that patients with corin levels above the median had a lower incidence of MACE and all-cause mortality compared with those whose corin levels were below the median. Multivariate Cox regression analysis suggested that log corin was an independent predictor of MACE (hazard ratio [HR], 0.61; 95% confidence interval [CI], 0.42-0.96; p = 0.029), together with age; prior histories of AMI, heart failure, and diabetes; Killip class; percutaneous coronary intervention; coronary artery bypass grafting; beta-blocker use; and log N-terminal pro-B-type natriuretic peptide (NT-proBNP). The C-statistic and integrated discrimination improvement for MACE were significantly improved by the addition of corin to the reference model. Moreover, log corin was also found to be a significant predictor of death (HR, 0.65; 95% CI, 0.41-0.97; p = 0.036) and HF hospitalization (HR, 0.48; 95% CI, 0.23-0.90; p = 0.009) after adjustment for clinical variables and established biomarkers of adverse prognosis.

Conclusions:

The authors concluded that corin is a valuable prognostic marker of MACE in patients with AMI, independent of established conventional risk factors.

Perspective:

This prospective cohort study suggests that corin could provide important prognostic information for AMI risk stratification and might be a useful biomarker of MACE in AMI patients. Furthermore, it appears that corin is a prognostic marker independent of established conventional risk factors, and may provide valuable information for the early risk stratification of AMI. These findings need to be validated in additional populations with different genetic backgrounds, and the prognostic ability of corin needs to be compared with other serum biomarkers, such as troponin I and NT-proBNP, in AMI patients.

Clinical Topics: Acute Coronary Syndromes, Cardiac Surgery, Invasive Cardiovascular Angiography and Intervention, Prevention, ACS and Cardiac Biomarkers, Aortic Surgery, Interventions and ACS, Hypertension

Keywords: Acute Coronary Syndrome, Adrenergic beta-Antagonists, Biological Markers, Coronary Artery Bypass, Diabetes Mellitus, Hypertension, Myocardial Infarction, Natriuretic Peptide, Brain, Percutaneous Coronary Intervention, Risk Factors, Troponin I


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