RESEARCH ARTICLE
The Utility of New Biomarker-based Predictive Model for Clinical Outcomes Among ST-elevation Myocardial Infarction Patients
Olga V. Petyunina1
Article Information
Identifiers and Pagination:
Year: 2020Volume: 10
First Page: 23
Last Page: 37
Publisher ID: TOBIOMJ-10-23
DOI: 10.2174/1875318302010010023
Article History:
Received Date: 09/01/2020Revision Received Date: 06/03/2020
Acceptance Date: 03/04/2020
Electronic publication date: 31/05/2020
Collection year: 2020
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Aim:
To determine the discriminative potency of score to prognosticate poor clinical outcomes in ST-Segment Elevation Myocardial Infarction (STEMI) patients.
Methods:
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.
Results:
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.
Conclusion:
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.
