High Human Antimicrobial Peptide LL-37 Level Predicts Lower Major Adverse Cardiovascular Events after an Acute ST-Segment Elevation Myocardial Infarction.
Zhao. Hanjun H; Sheng. Zhaoxue Z; Tan. Yu Y; Chen. Runzhen R; Zhou. Jinying J; Li. Jiannan J; Zhao. Qianyu Q; Wang. Ying Y; Zhao. Xiaoxiao X; Chen. Yi Y; Zhou. Peng P; Liu. Chen C; Song. Li L; Yan. Hongbing H
Key Findings
- Low plasma LL‑37 after STEMI is linked to a higher 3‑year rate of major adverse cardiovascular events (29.1% vs 12.6%)
- Higher LL‑37 independently predicts lower risk of MACE, all‑cause death, and repeat procedures (HR ~0.3‑0.4)
- LL‑37 level was measured by ELISA and split at the median for analysis
Practical Outcomes
- Measuring LL‑37 could help identify heart‑attack patients at higher risk for future events, but there’s currently no proven way for most people to safely raise LL‑37 levels. For biohackers, the finding suggests a potential biomarker to monitor, though actionable interventions are still experimental.
Summary
People who have higher natural levels of the antimicrobial peptide LL‑37 in their blood after a heart attack tend to have fewer serious heart problems over the next three years, while those with lower levels have more complications and higher death rates.
Abstract
We previously associated acute ST-elevation myocardial infarction (STEMI) with decreased plasma LL-37 levels. Therefore, this study investigated whether plasma LL-37 levels could predict ischemic cardiovascular events in patients after STEMI. We prospectively collected peripheral plasma samples and clinical and laboratory data from consecutive patients who presented with STEMI and underwent primary percutaneous coronary intervention at Fuwai Hospital between April and November 2017. Enzyme-linked immunosorbent assay measured plasma LL-37 levels, and we followed the patients for 3 years. Major adverse cardiovascular events (MACEs) were a composite of all-cause mortality, reinfarction, unscheduled revascularization, or ischemic stroke. The study included 302 patients divided into high (≥ median) and low LL-37 level (＜median) groups. The cumulative incidence of MACE (29.1% vs. 12.6%, p=0.0003), all-cause death (12.6% vs. 3.3%, p=0.003), reinfarction (7.1% vs. 2.0%, p=0.04), and unscheduled revascularization (13.0% vs. 5.4%, p=0.04) were higher in the low than those in the high LL-37 level group. Multivariable Cox regression analysis showed that higher LL-37 level independently predicted lower risks of MACE (hazard ratio [HR] 0.390; 95% confidence interval [CI] 0.227-0.669; p＜0.001), all-cause death (HR 0.324; 95%CI 0.119-0.879; p=0.027), and unscheduled revascularization (HR 0.391; 95%CI 0.171-0.907; p=0.027). High basal plasma level of human LL-37 may predict lower 3-year risks of ischemic cardiovascular events in patients after STEMI.
Study Information
pubmed
2021
2021-12-01T00:00:00.000Z
10.5551/jat.63221
10
31