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Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Circulating MIF Levels Predict Clinical Outcomes in Patients With ST-Elevation Myocardial Infarction After
Qian Zhao1, Li Men1, Xiao-Mei Li2
1State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
Insights
Admission macrophage migration inhibitory factor (MIF) levels are elevated in ST-elevation myocardial infarction (STEMI) patients. Higher MIF levels independently predict both in-hospital mortality and long-term adverse cardiovascular events after percutaneous coronary intervention.
Area of Science:
- Cardiology
- Biomarkers
- Clinical Outcomes
Background:
- Macrophage migration inhibitory factor (MIF) is implicated in inflammatory processes.
- Elevated MIF levels are observed in various cardiovascular conditions.
Purpose of the Study:
- To evaluate the predictive value of admission MIF levels for clinical outcomes in STEMI patients.
- To assess MIF's role in predicting mortality and major adverse cardio-and/or cerebrovascular events (MACCE).
Main Methods:
- Recruited 498 STEMI patients post-percutaneous coronary intervention (PCI).
- Measured plasma MIF levels at admission and post-PCI.
- Assessed in-hospital mortality and 3.2-year MACCE as primary endpoints.
Main Results:
- Admission MIF levels were significantly higher in STEMI patients compared to controls and stable angina.
- Higher admission MIF levels independently predicted in-hospital mortality (OR 9.1) and 3.2-year MACCE (HR 2.8).
- MIF demonstrated strong predictive value for in-hospital mortality, comparable to established markers.
Conclusions:
- Admission MIF is an independent predictor of adverse outcomes in STEMI patients undergoing PCI.
- Elevated MIF levels identify patients at higher risk for both short-term and long-term adverse events.
Background:
The purpose of the study was to assess the value of admission macrophage migration inhibitory factor (MIF) levels in predicting clinical outcomes in ST-elevation myocardial infarction (STEMI) patients.
Methods:
For this study we recruited 498 STEMI patients after they received percutaneous coronary intervention (PCI), 40 with stable angina pectoris and 137 healthy participants. Plasma MIF levels were measured at admission and after PCI. The primary end points were in-hospital mortality and major adverse cardio-and/or cerebrovascular events (MACCE) during hospitalization and 3.2-year follow-up period.
Results:
Admission MIF levels were elevated in 88.4% of STEMI patients over the upper reference limit of healthy controls and it was 3- to 7-fold higher than that in stable angina pectoris and control groups (122 ± 61 vs 39 ± 19 vs 17 ± 8 ng/mL; P < 0.001). Admission MIF levels were significantly higher in patients who died after myocardial infarction vs survivors. For predicting in-hospital mortality using the optimal cutoff value (127.8 ng/mL) of MIF, the area under the receiver operating characteristic curve for MIF was 0.820, similar area under the receiver operating characteristic curve values for predicting short-term outcomes were observed for high-sensitivity troponin T, CK-MB, N-terminal probrain natriuretic peptide, and Global Registry of Acute Coronary Events (GRACE) score. Although peak high-sensitivity troponin T and N-terminal probrain natriuretic peptide also predicted MACCE during the follow-up period, only higher admission MIF levels predicted in-hospital mortality and MACCE during the 3.2-year follow-up. Multivariate regression analysis showed the independent predictive value of a higher admission MIF level (≥ 127.8 ng/mL) on in-hospital mortality (odds ratio, 9.1; 95% confidence interval, 1.7-47.2) and 3.2-year MACCE (hazard ratio, 2.8; 95% confidence interval, 1.5-5.6).
Conclusions:
A higher admission MIF level is an independent predictor for in-hospital mortality and long-term MACCE in STEMI patients who underwent PCI.
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