Association of GSDMD with microvascular-ischemia reperfusion injury after ST-elevation myocardial infarction

Wenjing Sun; Chunqiu Wang; Shihua Cui; Yan Wang; Shenghui Zhao; Min Lu; Fan Yang; Shujuan Dong; Yingjie Chu

doi:10.3389/fcvm.2023.1138352

Association of GSDMD with microvascular-ischemia reperfusion injury after ST-elevation myocardial infarction

Front Cardiovasc Med. 2023 Jun 6:10:1138352. doi: 10.3389/fcvm.2023.1138352. eCollection 2023.

Authors

Wenjing Sun^#^{1

2}, Chunqiu Wang^#³, Shihua Cui^#⁴, Yan Wang³, Shenghui Zhao¹, Min Lu¹, Fan Yang⁵, Shujuan Dong¹, Yingjie Chu¹

Affiliations

¹ Department of Cardiology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.
² Microbiome Laboratory, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.
³ Department of Radiology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.
⁴ Department of Cardiology, Dalian Medical University, Dalian, China.
⁵ Department of Cardiology, Second Affiliated Hospital of Kunming Medical University, Kunming, China.

^# Contributed equally.

Abstract

Objectives: Little is known about the clinical prognosis of gasdermin D (GSDMD) in patients with ST-elevation myocardial infarction (STEMI). The purpose of this study was to investigate the association of GSDMD with microvascular injury, infarction size (IS), left ventricular ejection fraction (LVEF), and major adverse cardiac events (MACEs), in STEMI patients with primary percutaneous coronary intervention (pPCI).

Methods: We retrospectively analyzed 120 prospectively enrolled STEMI patients (median age 53 years, 80% men) treated with pPCI between 2020 and 2021 who underwent serum GSDMD assessment and cardiac magnetic resonance (CMR) within 48 h post-reperfusion; CMR was also performed at one year follow-up.

Results: Microvascular obstruction was observed in 37 patients (31%). GSDMD concentrations ≧ median (13 ng/L) in patients were associated with a higher risk of microvascular obstruction and IMH (46% vs. 19%, P = 0.003; 31% vs. 13%, P = 0.02, respectively), as well as with a lower LVEF both in the acute phase after infarction (35% vs. 54%, P < 0.001) and in the chronic phase (42% vs. 56%, P < 0.001), larger IS in the acute (32% vs. 15%, P < 0.001) and in the chronic phases (26% vs. 11%, P < 0.001), and larger left ventricular volumes (119 ± 20 vs. 98 ± 14, P = 0.003) by CMR. Univariable and multivariable Cox regression analysis results showed that patients with GSDMD concentrations ≧ median (13 ng/L) had a higher incidence of MACE (P < 0.05).

Conclusions: High GSDMD concentrations in STEMI patients are associated with microvascular injury (including MVO and IMH), which is a powerful MACE predictor. Nevertheless, the therapeutic implications of this relation need further research.

Keywords: GSDMD; IMH; MVO; ST-segment elevation myocardial infarction; magnetic resonance imaging; microvascular dysfunction.

Grants and funding

This work was supported in part by Henan Province Joint Construction Project (grant No. LH-GJ20210046), Henan Province Science and Technology Research Project (grant No. 122102310068). Fundamental Research Program of Yunnan Provincial Department of Science and Technology (Kunming Medical Joint Special Project) (grant No. 2018FE001(-236)).