Predictive value of circulating cardiomyocyte-specific cell-free DNA levels for heart failure risk after acute...

Area of Science:

• Cardiology
• Biomarker Discovery

Background:

• Heart failure (HF) onset after acute ST-segment elevation myocardial infarction (STEMI) indicates disease progression and poor prognosis.
• Identifying reliable biomarkers for HF risk prediction post-STEMI is crucial for patient management.

Purpose of the Study:

• To evaluate circulating cardiomyocyte-specific cell-free DNA (CS cfDNA) as a predictive biomarker for HF development following STEMI.
• To compare the predictive performance of CS cfDNA against established biomarkers like NT-proBNP and sST2.

Main Methods:

• 146 STEMI patients were enrolled and stratified into two groups based on admission CS cfDNA levels (≤164 copies/ml vs. >164 copies/ml).
• Patients were followed for approximately 355 days to monitor HF onset.
• Receiver Operating Characteristic (ROC) curve analysis and Cox proportional hazards regression were employed.

Main Results:

• The high CS cfDNA group (>164 copies/ml) exhibited a significantly higher prevalence of HF (77.4%) compared to the low CS cfDNA group (18.3%, p < 0.001).
• CS cfDNA demonstrated a strong predictive performance for HF post-STEMI with an Area Under the Curve (AUC) of 0.838, outperforming NT-proBNP (AUC=0.726) and sST2 (AUC=0.635).
• Elevated CS cfDNA levels were independently associated with increased HF risk (HR=2.804, p=0.035) and showed a positive correlation with cardiac injury markers.

Conclusions:

• Circulating cardiomyocyte-specific cell-free DNA (CS cfDNA) is a significant and independent predictor of heart failure following STEMI.
• CS cfDNA represents a promising novel biomarker for early risk stratification and clinical management of STEMI patients.
• Further research into CS cfDNA could enhance prognostic evaluation and therapeutic strategies for post-STEMI care.