The Utility of New Biomarker-based Predictive Model for Clinical Outcomes Among ST-elevation Myocardial Infarction Patients

To determine the discriminative potency of score to prognosticate poor clinical outcomes in ST-Segment Elevation Myocardial Infarction (STEMI) patients.

From the entire population of STEMI (n=268), we enrolled 177 individuals with acute STEMI who underwent complete revascularization with primary Percutaneous Coronary Intervention (PCI). Clinical assessment, echocardiography, Doppler, and biomarkers’ measure were performed at baseline.

Combined endpoint (Major Cardiovascular Events - MACEs [composite of cardiovascular death, recurrent myocardial infarction, newly diagnosed Heart Failure] and hospitalization) was determined in 75 patients with acute STEMI population (40.6%). Newly onset heart failure (HF) was reported in 46 patients (26.0%), Cardiovascular (CV) death occurred in 12 patients (6.8%), MACEs were determined in 58 patients (32.8%), and recurrent hospitalization due to CV reasons was found in 17 (9.6%). The conventional risk predictive models were engineered by a combination of TIMI risk score +acute HF Killip class ≥ II + the levels of NT-pro brain natriuretic peptide > 300 pg / mL and troponin >0.05 ng/mL. We developed a new predictive model based on the presentation of T786С genotype of endothelial NO syntase gene (rs 2070744), А1166С in angiotensin-ІІ receptor-1 gene (rs5186) and serum levels of soluble suppressor tumorigenicity ≥35 pg/mL, vascular endothelial growth factor ≤172 pg/mL and macrophage inhibitory factor ≥2792.7 pg/mL. STEMI patients who had >5 score points demonstrated significantly worse prognosis than those who had ≤5 score points.

Here we have reported that a new original predictive model is better than a conventional model in discriminative ability to predict combined clinical outcome in STEMI patients.