Relationship of plasma neuropeptide Y with angiographic, electrocardiographic and coronary physiology indices of reperfusion during ST elevation myocardial infarction

Heart. 2013 Aug;99(16):1198-203. doi: 10.1136/heartjnl-2012-303443. Epub 2013 Feb 12.


Objectives: The co-transmitter neuropeptide Y (NPY) is released during high levels of sympathetic stimulation and is a potent vasoconstrictor. We defined the release profile of plasma NPY during acute ST elevation myocardial infarction, and tested the hypothesis that levels correlate with reperfusion measures after treatment with primary percutaneous coronary intervention (PPCI).

Design: Prospective observational study.

Setting: University hospital heart centre.

Patients: 64 patients (62.6±11.7 years-old, 73% male) presenting throughout the 24-h cycle of clinical activity with ST elevation myocardial infarction.

Interventions: PPCI.

Main outcome measures: NPY was measured (ELISA) in peripheral blood taken before and immediately after PPCI and at 6, 24 and 48 h post-PPCI. Reperfusion was assessed by angiographic criteria, ST segment resolution, invasive measurement of coronary flow reserve and the index of microcirculatory resistance.

Results: Plasma NPY levels were highest before PPCI (17.4 (8.8-42.2) pg/ml, median (IQR)) and dropped significantly post-PPCI (12.4 (6.5-26.7) pg/ml, p<0.0001) and after 6 h (9.0 (2.6-21.5) pg/ml, p=0.008). Patients with admission NPY levels above the median were significantly more hypertensive and tachycardic and were more likely to have diabetes mellitus. Patients with angiographic no-reflow (less than thrombolysis in myocardial infarction 3 flow and myocardial blush grade >2, n=16) or no electrocardiographic ST resolution (<70%, n=30) following PPCI had significantly higher plasma NPY levels. Patients with a coronary flow reserve <1.5 or index of microcirculatory resistance >33 also had significantly higher plasma NPY levels pre-PPCI and post-PPCI.

Conclusions: Plasma NPY levels correlate with indices of reperfusion and coronary microvascular resistance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Analysis of Variance
  • Biomarkers / blood
  • Chi-Square Distribution
  • Coronary Angiography*
  • Coronary Circulation*
  • Electrocardiography*
  • England
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Hospitals, University
  • Humans
  • Male
  • Microcirculation
  • Middle Aged
  • Myocardial Infarction / blood
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / physiopathology
  • Myocardial Infarction / therapy*
  • Neuropeptide Y / blood*
  • No-Reflow Phenomenon / blood
  • No-Reflow Phenomenon / etiology
  • No-Reflow Phenomenon / physiopathology
  • Percutaneous Coronary Intervention* / adverse effects
  • Percutaneous Coronary Intervention* / instrumentation
  • Predictive Value of Tests
  • Prospective Studies
  • Risk Factors
  • Stents
  • Time Factors
  • Treatment Outcome
  • Vascular Resistance


  • Biomarkers
  • Neuropeptide Y