Key result
Sex-divergent immune cell profiles correlate with myocardial and hepatic injury markers in acute MI.
Why the study?
Gender differences exist in the pathological process and outcome of acute myocardial infarction, but inflammatory responses remain to be clarified.
Do correlations between peripheral immune cell counts and organ injury or cardiac function parameters differ between male and female patients with acute myocardial infarction undergoing primary PCI?
Cohort (n=603)
No
Do correlations between peripheral immune cell counts and organ injury or cardiac function parameters differ between male and female patients with acute myocardial infarction undergoing primary PCI?
This study demonstrates sex-specific immune cell correlations with organ injury in acute myocardial infarction—highlighting neutrophils and monocytes in males versus lymphocytes in females—which may inform sex-tailored risk stratification post-PCI.
Sex-specific immune correlations with injury markers may support hypothesis-generating risk models in AMI; leaves open prospective validation before clinical use.
Background: There are clear gender differences in the pathological process and outcome in acute myocardial infarction (AMI) patients but inflammatory responses remain clarified. Here, we aimed to analyse the correlations between inflammatory cells and organ injury parameters in AMI patients and compared between male and female groups. Methods: A total of 603 AMI patients who underwent percutaneous coronary intervention (PCI) within 24 hours of the onset were analysed retrospectively. Basic information and hematological parameters detected 6 hours before the PCI were collected, neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR) were calculated. Renal, liver function indicators, and myocardial enzymes were measured. Left ventricular ejection fraction (EF) and fractional shortening (FS) on days 5-7 after PCI were obtained. Western blot was performed to detect iNOS, eNOS and nNOS expression in H9C2 rat cardiomyocytes treated with IL-6 with and without estrogen and testosterone. Results: WBC, NEU, MON, MLR, CK, ALT and CREA of male patients were significantly higher than females, but FS was lower in females. NEU, MON and MLR were positively correlated with CK, CK-MB, AST, and ALT in males, whereas LYM were correlated with these parameters in female. NEU and NLR were inversely correlated with EF or FS only in female. Estrogen and testosterone reduced IL-6-induced iNOS protein expression in H9C2 cardiomyocytes, estrogen enhanced IL-6-induced nNOS protein expression. Conclusion: NEU, MON, MLR in male AMI patients, and LYM in female patients were associated with organ injury parameters. Estrogen regulation of nitric oxide pathway may mediate the protective effects in female.
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Song et al. (2022) conducted a cohort in Acute myocardial infarction with ST elevation undergoing primary percutaneous coronary intervention (n=603). Male sex (and sex-stratified peripheral immune cell counts including WBC, NEU, LYM, MON, NLR, MLR) vs. Female sex was evaluated on Correlations between peripheral immune cells (WBC, NEU, LYM, MON, NLR, MLR) and organ injury/cardiac function parameters (CK, CK-MB, AST, ALT, CREA, EF, FS) (p=<0.001). Male AMI patients showed positive correlations of NEU, MON, and MLR with CK, CK-MB, AST, and ALT (p<0.05), whereas female patients showed positive correlations with LYM (r=0.286-0.328, p<0.001).
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