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Association of Serum BAFF Levels with Cardiovascular Events in ST-Segment Elevation Myocardial Infarction
Ziyang Wang1,2, Yueying Wang1,2, Yuke Cui1,2
1Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Insights
Higher B cell activating factor (BAFF) levels predict worse outcomes in ST-segment elevation myocardial infarction (STEMI) patients. Elevated BAFF independently indicates increased risk for major adverse cardiovascular events (MACEs) and cardiovascular death post-STEMI.
Area of Science:
- Cardiology
- Immunology
- Biomarker Research
Background:
- B cell activating factor (BAFF) is a key B cell survival factor.
- BAFF plays a role in atherosclerosis and ischemia-reperfusion (IR) injury.
- Its predictive role in ST-segment elevation myocardial infarction (STEMI) requires investigation.
Purpose of the Study:
- To determine if BAFF levels can predict adverse outcomes in STEMI patients.
- To assess BAFF as a potential prognostic biomarker for major adverse cardiovascular events (MACEs).
Main Methods:
- Prospective enrollment of 299 STEMI patients.
- Measurement of serum BAFF levels.
- Three-year follow-up for MACEs (cardiovascular death, reinfarction, heart failure hospitalization, stroke).
- Multivariable Cox proportional hazards models and Kaplan-Meier survival analysis.
Main Results:
- BAFF was an independent predictor of MACEs (adjusted HR 1.525, p=0.015) and cardiovascular death (adjusted HR 3.632, p=0.030).
- Patients with BAFF > 1.46 ng/mL had significantly higher MACEs and cardiovascular death rates (log-rank p < 0.0001).
- BAFF improved MACE prediction when added to traditional risk factors or cardiac troponin I.
Conclusions:
- Elevated BAFF levels in the acute phase of STEMI are an independent predictor of MACEs.
- BAFF serves as a valuable prognostic biomarker in STEMI patients.
- Further research may explore BAFF-targeted therapies for STEMI management.
Objectives:
The B cell activating factor (BAFF) is a B cell survival factor involved in atherosclerosis and ischemia-reperfusion (IR) injury. This study sought to investigate whether BAFF is a potential predictor of poor outcomes in patients with ST-segment elevation myocardial infarction (STEMI).
Methods:
We prospectively enrolled 299 patients with STEMI, and serum levels of BAFF were measured. All subjects were followed for three years. The primary endpoint was major adverse cardiovascular events (MACEs), including cardiovascular death, nonfatal reinfarction, hospitalization for heart failure (HF), and stroke. Multivariable Cox proportional hazards models were constructed to analyze the predictive value of BAFF for MACEs.
Results:
In multivariate analysis, BAFF was independently associated with risk of MACEs (adjusted HR 1.525, 95% CI 1.085-2.145; p = 0.015) and cardiovascular death (adjusted hazard ratio [HR] 3.632, 95% confidence interval [CI] 1.132-11.650, p = 0.030) after adjustment for traditional risk factors. Kaplan-Meier survival curves demonstrated that patients with BAFF levels above the cut-off value (1.46 ng/mL) were more likely to have MACEs (log-rank p < 0.0001) and cardiovascular death (log-rank p < 0.0001). In subgroup analysis, the impact of high BAFF on MACEs development was stronger in patients without dyslipidemia. Furthermore, the C-statistic and Integrated Discrimination Improvement (IDI) values for MACEs were improved with BAFF as an independent risk factor or when combined with cardiac troponin I.
Conclusions:
This study suggests that higher BAFF levels in the acute phase are an independent predictor of the incidence of MACEs in patients with STEMI.
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