Association of Plasma Nucleotide levels with severity of Coronary Arterial lesion and left ventricular systolic Function in Acute Myocardial infarction

Background: Purinergic receptors can be divided into adenosine (P1) and adenosine 5’-triphosphate (ATP) (P2) receptors, which play crucial roles in regulating vessel tone, arthrosclerosis, myocardial preconditioning and heart function. However, the relationship of plasma nucleotides with coronary artery disease (CAD) and heart function have not been reported. Methods and results: Total 97 patients undergoing coronary angiogram had been tested for the plasma nucleotides, including ATP, uridine 5’-triphosphate (UTP) and adenosine monophosphate (AMP), and their association with CAD and heart function. They were divided into ST-elevation myocardial infarction (STEMI, n=33) group, unstable angina (UA, n=33) group and control (normal angiography, n=31) group. The UTP (1263.23 ± 137.76 vs. 635.61 ± 124.82 nmol/L, P<0.05), ATP (2750.38 ± 215.52 vs. 1903.33 ± 478.80 nmol/L, P<0.05) and AMP levels (1771.06 ± 165.86 vs. 1050.15 ± 124.58 nmol/L, P<0.05) in STEMI group were significantly higher compared to baseline. However, ATP level in UA group was significantly lower than control group (335.33 ± 79.49 vs. 1903.33 ± 478.80 nmol/L, P<0.05). The UTP level had positive correlation with cardiac enzymes and the severity of coronary arterial lesion by Gensini score. Particularly, the plasma UTP level had negative correlation with post-infarction left ventricular ejection fraction (LVEF) within 24 hours (r2=0.46, P<0.01). Conclusion: Plasma nucleotides levels have significant association with the myocardial damage, severity of coronary arterial lesion and left ventricular systolic function in acute myocardial infarction.