Cinética y valor pronóstico de la proteína de unión a la heparina en la miocardiopatía de infarto con elevación del...

This research aimed to explore the potential role of heparin-binding protein (HBP) as a prognostic biomarker for adverse events among individuals diagnosed with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (pPCI).

This cohort study enrolled 215 consecutive patients with STEMI following pPCI. Plasma HBP and high-sensitivity cardiac troponin I (hs-cTnI) levels were measured at admission, and at 24h, 48h, and 72h after pPCI. During a median follow-up period of 1.5 years, major adverse cardiovascular events (MACE) were recorded.

Plasma HBP levels decreased from a median of 58.04 (IQR 30.38, 106.04) ng/mL at admission to 23.80 (IQR 14.03, 44.51) ng/mL at 72 h (HBP_72h) after pPCI (p < 0.001). HBP levels demonstrated a moderate correlation with hs-cTnI, particularly at 72 h post-pPCI (r = 0.56). Multivariable Cox regression analysis demonstrated that the highest HBP_72h quartile was independently associated with a 5-fold increased risk of MACE during follow-up compared to the lowest quartile (hazard ratio, 5.156; 95% confidence interval, 1.380, 19.271; p = 0.0148). The ROC curve demonstrated that an HBP_72h cut-off level of 29.12 ng/mL for predicting MACE had a specificity of 78.0% and a sensitivity of 61.9%, with an AUC of 0.730. Furthermore, adding HBP_72h to hs-cTnI improved MACE prediction compared to hs-cTnI alone (NRI 0.578; p < 0.001).

Elevated HBP levels following STEMI were associated with an increased risk of adverse outcomes and may serve as a novel and valuable prognostic marker in patients with STEMI.