Unraveling the Clinical and Molecular Landscape of Myocardial Infarction in Behçet's Syndrome: A Comprehensive...

Behçet's syndrome (BS) is a rare inflammatory disorder with life-threatening complications like myocardial infarction (MI), driven by vasculitis and immune-mediated thrombosis. This study unveils distinct clinical and molecular profiles in BS patients with MI, employing gene analysis and Weighted Gene Co-expression Network Analysis (WGCNA) to pinpoint critical pathways and therapeutic targets, enhancing diagnostic precision and treatment efficacy.

A total of 2358 BS patients (25 with MI, 2333 without MI) were analyzed. Clinical characteristics were compared based on the cohort. Differential gene expression analysis was performed on four microarray datasets, by using GEO datasets, and WGCNA identified key gene modules. KEGG/GO enrichment revealed disease pathways, while diagnostic models (ROC curves, nomograms) evaluated predictive accuracy.

BS patients with MI exhibited longer disease duration, higher smoking rates, and increased vascular and cardiac involvement. Gene analysis identified 605 BS- and 523 MI-related genes, with pathways linked to immune regulation and vascular remodeling. Three genes, TLR5, IL2RB, and KLRB1, showed strong diagnostic potential (AUC > 0.8). A nomogram integrating these genes achieved high predictive accuracy (AUC = 0.876).

This study reveals distinct clinical and molecular profiles in BS-associated MI, emphasizing inflammatory pathways and immune dysregulation. The findings provide a foundation for early diagnosis and personalized therapeutic strategies, advancing care for BS patients at risk for MI.