Trajectories of Circulating Monocyte Subsets After ST-Elevation Myocardial Infarction During Hospitalization: Latent...

Area of Science:

• Cardiovascular Medicine
• Immunology
• Biomarker Research

Background:

• The predictive value of inflammatory biomarker developmental trajectories in acute ST-elevation myocardial infarction (STEMI) remains uncertain.
• Assessing longitudinal changes in specific monocyte subsets may offer novel prognostic insights.

Purpose of the Study:

• To investigate the association between developmental trajectories of CD14++CD16+ monocytes and cardiovascular outcomes in STEMI patients.
• To determine if latent class growth modeling (LCGM) of monocyte patterns can improve risk stratification post-STEMI.

Main Methods:

• Latent class growth modeling (LCGM) was applied to serial flow cytometry data of CD14++CD16+ monocytes from day 1 to day 7 post-STEMI onset.
• The study included 96 de novo STEMI patients who underwent primary percutaneous coronary intervention.
• Prediction models were compared with and without the inclusion of monocyte trajectory data.

Main Results:

• Three distinct CD14++CD16+ monocyte trajectories were identified.
• Membership in the high-hump-shaped trajectory (16.8% of patients) independently predicted adverse cardiovascular outcomes over 2.5 years.
• Incorporating monocyte trajectories significantly improved the area under the curve (AUC) of a prediction model based on left ventricular ejection fraction (ΔAUC = 0.093, P = 0.013).

Conclusions:

• Longitudinal trajectories of CD14++CD16+ monocytes during STEMI hospitalization represent a novel risk factor for adverse post-STEMI outcomes.
• LCGM-based analysis of inflammatory marker dynamics offers a promising approach for risk stratification in acute myocardial infarction.