Abstract 15021: Kinetics and Prognosis Value of Rantes (ccl5) at the Acute Phase of Stemi

Introduction: CCL5 or RANTES is a chemokine that mediates chemotaxis and activation of T cells, monocytes, granulocytes, mast cells and dendritic cells. It is involved in the pathogenesis of several diseases including atherosclerosis but little is known about its role at the acute phase of myocardial infarction (MI). Hypothesis: We questioned whether the serum level of RANTES might be a marker of the severity of acute MI. Methods: We prospectively enrolled 251 consecutive STEMI patients who underwent PCI into a prospective cohort. Blood samples were collected at 5 time points: admission, 4, 24, 48 hours and 1 month after admission (H4, H24, H48, M1). RANTES serum levels were assessed using an ELISA assay. Patients underwent cardiac magnetic resonance imaging at one month. Clinical outcomes were prospectively recorded over 12 months. Results: Mean age of the study population was 59±12 years and 54.6% patients exhibited anterior MI. Serum RANTES level raised from 12.6 [7.6-20.8] ng/mL at H0 to 13.9 [7.6-20.8] ng/mL at H4 and decreased gradually until 1 month at 9.3 [4.9-13.6] ng/mL (Kruskal-Wallis test, p<0.0001). RANTES area under curve (AUC) level was not correlated with IS (r =-0.03, p=0.70) or LVEF assessed by MRI (r=0.02, p=0.80). Patient with a RANTES AUC serum level below the first tertile value of the population (411.0 ng.h.mL -1 ) were more likely to have a MACE during the first 12 months after STEMI (hazard ratio at 2.9 (1.3-6.6), p=0.01). In a multivariable Cox regression analyses with a model including age, gender, troponin peak, and TIMI flow grade after PCI, RANTES AUC serum level below the first tertile remained associated with an increased risk of experiencing MACE during the 12 months of follow-up (adjusted HR = 2.6 (1.2-5.8), p=0.02) Conclusion: A low level of circulating RANTES at the acute phase of STEMI was independently associated with an increased risk of experiencing MACE in our population. Serum RANTES might be a valuable prognostic marker in STEMI patients.