Diagnostic Biomarkers for Risk Estimation of In-Hospital and Post-Discharge Cardiovascular Mortality in ST-Segment...

Area of Science:

• Cardiovascular Medicine
• Biomarker Discovery
• Clinical Risk Stratification

Background:

• ST-segment-elevation myocardial infarction (STEMI) remains a leading cause of cardiovascular mortality despite treatment advancements.
• Early and accurate risk stratification is crucial for improving STEMI patient outcomes.
• Emerging biomarkers such as C-reactive protein (CRP), soluble ST2 (sST2), and fatty acid-binding protein (FABP) may improve predictive accuracy beyond traditional markers.

Purpose of the Study:

• To evaluate the prognostic value of CRP, sST2, and H-FABP for in-hospital and 18-month post-discharge cardiovascular mortality in STEMI patients.
• To determine if these novel biomarkers enhance risk prediction in STEMI.

Main Methods:

• Prospective, single-center study of 179 consecutive STEMI patients.
• Serum CRP, sST2, and H-FABP levels measured upon admission using ELISA.
• 18-month follow-up for mortality assessment; ROC, Cox regression, and Kaplan-Meier analyses employed.

Main Results:

• In-hospital mortality was 7.8%. Elevated CRP (>11 mg/L) significantly predicted higher in-hospital mortality (21.4% vs. 3.7%, p < 0.01).
• CRP > 11 mg/L, admission glucose, and reduced GFR were independent predictors of in-hospital mortality.
• During 18-month follow-up, 10.1% of discharged patients died from cardiovascular causes. Higher sST2 levels were significantly associated with midterm cardiovascular mortality (p = 0.041).

Conclusions:

• CRP > 11 mg/L is a potent predictor of in-hospital mortality in STEMI.
• Elevated sST2 levels are associated with cardiovascular mortality during midterm follow-up in STEMI patients.
• Incorporating CRP and sST2 into clinical risk models may improve early risk prediction and identify high-risk patients for post-discharge events.