Can Glypican-6 Levels Be Used In The Determination Of Right Ventricular Remodelling After Non-ST Segment Elevation Myocardial Infarction?

OBJECTIVE
Myocardial infarction is associated with right ventricular (RV) remodelling. Glypican-6 (GPC6) is a member of the membrane proteoglycan family and plays an important role in cardiac remodelling. The purpose of our study was to determine whether GPC6 could predict RV remodeling after percutaneous coronary intervention (PCI) in patients with non-ST segment elevation myocardial infarction (NSTEMI).

METHODS
The study enrolled 164 consecutive NSTEMI and control group patients. Comparison of baseline plasma GPC6 levels, echocardiography, and laboratory parameters between RV remodelling and non-RV remodelling with NSTEMI. Echocardiographic data measured at baseline and at 6 months.

RESULTS
The GPC6 levels were higher in the NSTEMI group (11.06 (4.61-18.17), 5.98 (3.81-9.83) in comparison to the control group in the first phase. The incidence of RV remodelling (≥20% increase in RV end-diastolic area [RV EDA]) was observed in 23 patients (30%). After 6 months, RV EDA increased significantly from baseline (18.68±1.20 vs. 24.91±1.08, P <.001). GPC6 was a significant independent predictor of RV remodelling (hazard ratio [HR]: 1.546, 95% confidence interval [CI]: 1.056-2.245, P <.001). Receiver operating characteristic curve (ROC) analyses showed that GPC6 values > 15.5 ng/mL (AUC = 0.828, sensitivity: 70%, specificity: 74%, P <.001) were strong predictors of RV remodelling.

CONCLUSION
NSTEMI patients should be closely monitored for RV remodelling. It seems that GPC6 is useful in detecting RV remodelling following NSTEMI in patients undergoing PCI.