Lim Joyce, Williams Trent, Murtha Lucy, Mabotuwana Nishani, Kelly Conagh, Ngo Doan, Boyle Andrew
Heart and Stroke Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia.
Int J Cardiol Cardiovasc Risk Prev. 2025 Mar 6;25:200383. doi: 10.1016/j.ijcrp.2025.200383. eCollection 2025 Jun.
Eosinophils have been implicated in mediating the inflammatory response after ST-elevation myocardial infarction (STEMI), but its role as a biomarker predicting major adverse cardiovascular events (MACE) remains unclear. We aimed to evaluate the predictive value of eosinophil response on 30-day and 1-year MACE post primary percutaneous coronary intervention (PCI) after STEMI.
Single centre retrospective cohort study of STEMI patients undergoing PCI. Eosinophil response was defined as the change in peripherally circulating eosinophils cell count at admission minus 48 h post primary PCI. Primary endpoints were 30-day and 1-year MACE. Receiver operating characteristic (ROC) curves were created to identify optimal cut-off predicting MACE. Multivariate logistic regression analyses were used to determine if the ROC cut-off was an independent predictor of MACE.
Of the 366 patients in this study (median age 61 years [53.0-71.0]; 267 males [73 %]), 41 patients (11.2 %) and 78 patients (21.3 %) developed MACE at 30-days and 1-year. The optimal ROC curve cut-off predicting MACE was an eosinophil response of greater than -0.05 × 10^9/L (ΔEos > -0.05). It had a sensitivity, specificity, and positive and negative predictive value of 83, 39, 6 and 98 % for 30-day MACE, and 74, 39, 19 and 88 % for 1-year MACE. An ΔEos > -0.05 change was associated with a threefold higher likelihood of MACE at 30-days ( 3.1 1.04-9.070.042), but not 1-year.
An eosinophil response of -0.05 × 10^9L at 48 h following primary PCI post STEMI is highly sensitive at predicting 30-day MACE, and in its absence, holds a high negative predictive value.
嗜酸性粒细胞被认为参与介导ST段抬高型心肌梗死（STEMI）后的炎症反应，但其作为预测主要不良心血管事件（MACE）生物标志物的作用仍不明确。我们旨在评估嗜酸性粒细胞反应对STEMI后初次经皮冠状动脉介入治疗（PCI）后30天和1年MACE的预测价值。
对接受PCI的STEMI患者进行单中心回顾性队列研究。嗜酸性粒细胞反应定义为入院时外周循环嗜酸性粒细胞计数减去初次PCI后48小时的变化。主要终点是30天和1年的MACE。绘制受试者工作特征（ROC）曲线以确定预测MACE的最佳临界值。采用多变量逻辑回归分析来确定ROC临界值是否为MACE的独立预测因子。
本研究中的366例患者（中位年龄61岁[53.0 - 71.0]；267例男性[73%]），41例患者（11.2%）和78例患者（21.3%）在30天和1年时发生MACE。预测MACE的最佳ROC曲线临界值是嗜酸性粒细胞反应大于 -0.05×10^9/L（ΔEos > -0.05）。对于30天MACE，其敏感性、特异性、阳性和阴性预测值分别为83%、39%、6%和98%；对于1年MACE，分别为74%、39%、19%和88%。ΔEos > -0.05的变化与30天时发生MACE的可能性高3倍相关（3.1 1.04 - 9.07 0.042），但1年时不相关。
STEMI后初次PCI后48小时嗜酸性粒细胞反应为 -0.05×10^9/L对预测30天MACE高度敏感，若不存在则具有高阴性预测价值。
