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Dynamic Complement Activation Predicts 12-Month Major Adverse Cardiovascular Events in Acute Coronary Syndromes
Florin-Leontin Lazar1,2, Paula Anderco3, Teodor Paul Kacso1,4
1Medical Clinic Number 1, "Iuliu Haţieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
Biomedicines
|July 28, 2026
Summary
Complement activation after percutaneous coronary intervention (PCI) in acute coronary syndromes (ACS) predicts adverse cardiovascular events. Changes in complement components C3 and C4 post-PCI indicate higher risk, offering prognostic value.
Area of Science:
- Cardiovascular Medicine
- Immunology
- Biochemistry
Background:
- The role of complement system activation in acute coronary syndromes (ACS) and its prognostic implications following percutaneous coronary intervention (PCI) requires further elucidation.
- Understanding complement's impact on ACS outcomes post-PCI is crucial for risk stratification.
Purpose of the Study:
- To investigate the prognostic significance of periprocedural complement activation dynamics in ACS patients undergoing PCI.
- To assess the association between changes in serum complement components (C3, C4) and major adverse cardiovascular events (MACE) after PCI.
Main Methods:
- Prospective study of 76 ACS patients undergoing PCI.
- Measurement of serum C3 and C4 levels pre-PCI and 24-48 hours post-PCI, calculating delta values (ΔC3, ΔC4).
- Analysis of 12-month MACE using logistic regression, Cox models, and Kaplan-Meier analysis.
Main Results:
- A total of 21 MACEs occurred during 12-month follow-up.
- Patients experiencing MACE exhibited significantly higher ΔC3 and ΔC4 values compared to those without MACE.
- Both ΔC3 and ΔC4 were independently associated with increased MACE risk and earlier event occurrence in multivariable analyses.
Conclusions:
- Periprocedural changes in complement activation following PCI are linked to adverse cardiovascular outcomes in ACS patients.
- Complement activation dynamics, specifically ΔC3 and ΔC4, may offer incremental prognostic value beyond traditional risk factors.
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