Cell-free DNA levels in acute myocardial infarction patients during hospitalization

Objectives - The objectives of this study were to investigate cell-free DNA daily concentration changes following an acute myocardial infarction (AMI) and to assess any correlations with complications during hospitalization. Methods and results - Serial cell-free DNA level determinations were performed by quantitative Real-Time PCR in 47 AMI patients once daily during hospitalization (235 samples) and once in 100 healthy subjects. Cell-free DNA concentrations are significantly higher in patients throughout hospitalization compared to healthy subject levels (2.644 (SE 0.0952) vs. 1.519 (SE 0.0566), P<0.001). The median maximum cell-free DNA concentration was 3.5-fold higher (Mann Whitney P = 0.0035) in 20/47 patients with complicated post AMI course - group I - (1719.7, range 117.32-4996212.1 GenEq/ml plasma) compared with 27/47 patients without complications - group II - (492.9, range 56.43471 S. 15 GenEq/ml plasma). Substantial differences exist between cell-free DNA concentrations measured on t(pre) (the day before the complication) and t(c) (the day the complication occurred) as well as t(post) (the day after the complication) in group I whereby cell-free DNA rises significantly in tc and remains elevated in t(post) (t(pra) vs. t(c), 2.445 vs. 2.965, P = 0.0171 and t(pre) vs. t(post) 2.445 vs. 2.913, P = 0.023). Conclusions - Cell-free DNA concentrations were elevated in AMI patients compared to healthy control subjects, rise significantly when complications occur and have a potential clinical value in monitoring patient progress during hospitalization.