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The Prognostic Value of Pre-Procedural and Post-Procedural Inflammatory-Oxidative Stress Biomarkers in Acute Coronary

Jonathan Samuel Matogu Tambunan1, Citrawati Dyah Kencono Wungu2,3, Hendri Susilo4,5,6

  • 1Faculty of Medicine, Medical Program, Universitas Airlangga, Surabaya 60132, Indonesia.

International Journal of Molecular Sciences
|May 4, 2026
PubMed

Insights

Pre-procedural inflammatory biomarkers like sST2 and GDF-15 effectively predict major adverse cardiovascular events in acute coronary syndrome patients undergoing PCI. Baseline measurements offer more reliable risk stratification than post-procedural ones.

Area of Science:

  • Cardiology
  • Biomarkers
  • Interventional Cardiology

Background:

  • Acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) face high risks of major adverse cardiovascular events (MACE).
  • Inflammatory and oxidative stress biomarkers are explored for prognostic value, but the impact of sampling timing (pre- vs. post-PCI) is unclear.

Purpose of the Study:

  • To evaluate the prognostic significance of six inflammatory-oxidative stress biomarkers (sST2, GDF-15, OPG, sLOX-1, H-FABP, Galectin-3) in ACS patients undergoing PCI.
  • To compare the predictive value of pre-procedural versus post-procedural biomarker measurements for MACE.

Main Methods:

  • A meta-analysis of 40 studies involving 18,933 patients.
  • Pooled Hazard Ratios (HRs) for time-to-event outcomes and Standardized Mean Differences (SMDs) were calculated using random-effects models.

Main Results:

  • Elevated pre-PCI sST2, GDF-15, sLOX-1, and OPG significantly predicted MACE.
  • Pre-PCI sST2 strongly predicted heart failure hospitalization (HR = 6.30).
  • Pre-PCI H-FABP showed a moderate significant effect (SMD = 0.67), while post-PCI Galectin-3 had a large significant effect (SMD = 1.15).

Conclusions:

  • Pre-procedural inflammatory and oxidative stress biomarkers, especially sST2 and GDF-15, are consistently associated with adverse outcomes in ACS patients post-PCI.
  • Baseline biomarker levels provide more reliable risk stratification compared to post-procedural measurements.

Keywords:
GDF-15acute coronary syndromebiomarkerscardiovascular diseasesoxidative stresspercutaneous coronary interventionprognosissST2

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