Imbalance Between Angiotensin II and Kallikrein in Patients With ST-Segment Elevation Myocardial Infarction: A Case-Control Emergency Room Study

Abstract

The present study aimed to investigate the balance between angiotensin II (Ang-II) and kallikrein (KLK1) in the pathogenesis of ST-segment elevation acute myocardial infarction (STEMI). The study included a total of 261 participants: 151 STEMI patients and 110 individuals with normal coronary arteries. The plasma levels of Ang-II and KLK1 were measured using enzyme-linked immunosorbent assays (ELISA). Multivariate logistic regression analysis indicated that the plasma levels of Ang-II, KLK1 and the ratio of Ang-II and KLK1 (Ang-II/KLK1) independently correlated with the presence of STEMI. Furthermore, we found independent associations between STEMI and smoking, cholesterol (CHO), high-density lipoprotein cholesterol (HDL-c), as well as age. The ratio of Ang-II/KLK1 correlated with the plasma level of the inflammatory cytokine, interleukin-6 (IL-6). Both Ang-II and KLK1 levels are significantly elevated in patients with STEMI. An increased Ang-II/KLK1 ratio may result in the over-activation of Ang-II and exacerbate the progression of STEMI( P = .046). In conclusion, we have demonstrated, for the first time, an Ang-II and KLK1 imbalance in patients with STEMI.