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Sci Rep. 2020 Mar 19;10(1):5007. doi: 10.1038/s41598-020-61971-7.

Double-Stranded DNA and NETs Components in Relation to Clinical Outcome After ST-Elevation Myocardial Infarction.

Author information

1
Center for Clinical Heart Research, Oslo University Hospital Ullevål, PB 4956 Nydalen, 0424, Oslo, Norway. m.s.langseth@studmed.uio.no.
2
Faculty of Medicine, University of Oslo, PB 1078 Blindern, 0316, Oslo, Norway. m.s.langseth@studmed.uio.no.
3
Center for Clinical Heart Research, Oslo University Hospital Ullevål, PB 4956 Nydalen, 0424, Oslo, Norway.
4
Department of Cardiology, Oslo University Hospital Ullevål, PB 4956 Nydalen, 0424, Oslo, Norway.
5
Faculty of Medicine, University of Oslo, PB 1078 Blindern, 0316, Oslo, Norway.
6
Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, PB 4950 Nydalen, 0424, Oslo, Norway.

Abstract

Neutrophil extracellular traps (NETs) have been implicated in atherothrombosis; however, their potential role as markers of risk is unclear. We investigated whether circulating NETs-related components associated with clinical outcome and hypercoagulability in ST-elevation myocardial infarction (STEMI). In this observational cohort study, STEMI patients admitted for PCI (n = 956) were followed for median 4.6 years, recording 190 events (reinfarction, unscheduled revascularization, stroke, heart failure hospitalization, or death). Serum drawn median 18 hours post-PCI was used to quantify double-stranded DNA (dsDNA) and the more specific NETs markers myeloperoxidase-DNA and citrullinated histone 3. Levels of the NETs markers did not differ significantly between groups with/without a primary composite endpoint. However, patients who died (n = 76) had higher dsDNA compared to survivors (p < 0.001). Above-median dsDNA was associated with an increased number of deaths (54 vs. 22, p < 0.001). dsDNA in the upper quartiles (Q) was associated with increased mortality (Q3 vs. Q1 + 2 adjusted HR: 1.89 [95% CI 1.03 to 3.49], p = 0.041 and Q4 vs. Q1 + 2 adjusted HR: 2.28 [95% CI 1.19 to 4.36], p = 0.013). dsDNA was weakly correlated with D-dimer (rs = 0.17, p < 0.001). dsDNA levels associated with increased all-cause mortality, yet weakly with hypercoagulability in STEMI patients. The prognostic significance of potentially NETs-related markers requires further exploration.

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