Association Between Serum Cathepsin S And Heart Failure In Acute Myocardial Infarction Patients

Objective To investigate the association between serum cathepsin S (CatS) and heart failure in acute myocardial infarction patients, and determine the diagnostic value of serum CatS as a biomarker in acute myocardial infartion with heart failure.Methods Patients who underwent selective coronary angiography in department of cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine from Jan1st,2013to Dec30th,2013were included in this study.147patients of acute myocardial infarction (including ST segmental elevated myocardial infarction and non-ST segmental elevated myocardial infarction),107patients of non-coronary heart disease and107patients of unstable angina pectoris were diagnosed according to their clinical manifestation, electrocardiogram, myocardial enzymogram and coronary angiogram. Based on the left ventricular ejection fraction (EF) estimated at the first echocardiogram after hospitalization, patients were divided into2groups as normal cardiac function and heart failure. Arterial blood samples were collected before coronary angiography. Serum CatS level was detected by ELISA according to the manufacturer’s manual. SPSS20.0software was used for statistical analysis, and P<0.05was considered to be statistically significant.Results Average age was elder in the normal cardiac function group when comparing to the heart failure group (64.92±12.02years vs61.22±12.60, P=0.03), while no difference was found in other baseline parameters in the2groups. Median of serum CatS levels in normal cardiac function and heart failure groups were6.68ng/ml (range5.55-7.77ng/ml) versus7.12ng/ml (range5.42-8.49ng/ml) and without statistical significance (P=0.7058). No continuous association were found in the2groups after adjusting by age and gender (OR=1.05,95%CI0.93-1.12). Serum CatS levels were divided at the3rd quintile as a low or high level after adjusting for age, gender, BMI, history of cigarette smoking, hypertension, dyslipidemia, diabetes, peripheral arterial disease, cerebrovascular disease and chronic lung disease. No association was found in non-coronary heart disease patients (OR=0.86,95%CI0.14～5.52) and unstable angina pectoris patients (OR=2.21,95%CI0.53-9.22). However, among the acute myocardial infarction patients, higher serum CatS levels were associated with heart failure (OR=5.61,95%CI1.27-24.75).Conclusion Serum CatS level is associated with heart failure in acute myocardial infarction patients. Serum CatS level might be an independent biomarker indicating heart failure in acute myocardial patients as an alternative method for echocardiography.