Why the study?
JKAP knockdown facilitates atherosclerotic progression via CD4+ T-cell differentiation, but its correlation with CD4+ T-cell subtypes and prognosis in ACS patients undergoing PCI was unknown.
Does serum JKAP level predict MACE and physical performance in ACS patients undergoing PCI?
Does serum JKAP level predict MACE and physical performance in ACS patients undergoing PCI?
Serum JKAP levels are reduced in ACS patients, and higher levels post-PCI independently predict a lower risk of MACE and better physical performance.
Serum JKAP may aid post-PCI risk stratification in ACS; leaves open clinical utility pending prospective validation.
Objective Our previous studies revealed that knockdown of JNK pathway-associated phosphatase (JKAP) facilitates atherosclerotic progression by regulating CD4 + T-cell differentiation. Moreover, CD4 + T-cell subtypes are dysregulated and can serve as a prognosis biomarker in acute coronary syndrome (ACS) patients who have undergone percutaneous coronary intervention (PCI). This study aims to further investigate the correlation between JKAP with CD4 + T-cell subtypes and prognosis in ACS patients who have undergone PCI. Methods This study included 173 ACS patients, for whom serum JKAP levels were detected before PCI and 1 month (M1) after PCI via an enzyme-linked immunosorbent assay. Short physical performance battery (SPPB) scores at M1 and major adverse cardiac event (MACE) data were collected. Moreover, serum JKAP levels were detected in 32 healthy control subjects. Results JKAP levels were significantly lower in ACS patients vs. healthy control subjects ( P < 0.001) and were increased at M1 after PCI vs. before PCI in ACS patients ( P < 0.001). JKAP negatively correlated with T-helper (Th)17 cells ( P = 0.002) and tended to negatively associate with Th1 cells ( P = 0.060), but did not correlate with Th2 or T-regulatory cells. Importantly, JKAP before PCI and at M1 after PCI showed good values in predicting MACE risk via receiver operating curve analyses [area under curve (AUC) = 0.721, AUC = 0.778, respectively]; however, JKAP demonstrated relatively weaker values in predicting an SPPB score of ≤6 points at M1 (AUC = 0.638, AUC = 0.649, respectively). Multivariable analyses revealed that JKAP at M1 after PCI independently predicted a lower risk of MACE ( P = 0.045) and an SPPB score of ≤6 points at M1 ( P = 0.025). Conclusion JKAP may serve as a prognostic biomarker in ACS patients who have undergone PCI.
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