Oncostatin M is associated with a higher risk profile and predicts a worse outcome in patients with STEMI

Background Oncostatin M (OSM) is a cytokine that plays an important role in inflammation. Increased levels of circulating OSM are associated with heart failure in patients with reduced left ventricular ejection fraction (LVEF) and with acute coronary syndrome in patients with diabetes. Purpose The aim of this study was to evaluate the dynamics of circulating OSM levels during the acute phase of ST-elevation acute myocardial infarction (STEMI) and its role as a prognostic biomarker. Methods Patients with STEMI who underwent primary percutaneous coronary intervention in the first 12 hours were prospectively included. Plasma levels of OSM were measured in peripheral blood on admission and 24 hours after symptom-onset. The association of OSM concentrations with clinical variables was analysed. The clinical primary endpoint was a composite of all-cause mortality or readmission due to heart failure (HF) at 1 year. Results 527 patients (mean age 61 years, 19% female, 13% Killip class II-IV) were studied. Globally, OSM levels were similar on admission (44.01 [23.77 - 98.55] pg/mL) and at 24h (44.34 [21.42 - 108.22] pg/mL). However, older patients, women, patients with diabetes, lower creatinine clearance, haemoglobin and LVEF, and those complicated with ventricular fibrillation and heart failure, exhibited higher levels at 24h (p<0.05 for all). Multivariable Cox regression analysis showed that OSM levels (log2) at 24h were independently associated with 1-year all-cause mortality and HF readmission (HR, 1.32; 95% CI, 1.09 - 1.60) after adjustment by age, sex, diabetes, Killip class, LVEF and creatinine clearance. The association of OSM with the primary endpoint was not significative for the admission levels (HR 1.14 [0.93 - 1.40]) nor the difference between admission and 24h (HR 1.13 [0.95 - 1.34]). Conclusions Increased levels of OSM are associated with a highest risk profile in patients with STEMI, and independently predict a worse outcome when measured at 24h after symptom-onset.