Key result
Elevated 24-hour PIV is linked to a ~5-fold higher MACE risk after STEMI PCI.
Why the study?
Patients with STEMI remain at high risk of MACE after timely PCI, prompting evaluation of the prognostic value of dynamic RvD1, sST2, and PIV levels within 24 hours of onset.
Cohort (n=184)
No
Odds Ratio: 5.139 (95% CI 1.743–15.154)
p-value: p=<0.001
Early dynamic changes in RvD1, sST2, and PIV, particularly sST2 at admission and RvD1 and LnPIV at 24 hours, are strong independent predictors of MACE in STEMI patients after PCI, improving risk stratification when added to the GRACE score.
Introduction ST-segment elevation myocardial infarction (STEMI) is one of the major subtypes of acute coronary syndrome, with rapid progression and a high risk of death and disability. Although some patients undergo timely percutaneous coronary intervention (PCI), they remain at high risk of major adverse cardiovascular events (MACE) after the procedure. In our study, we analyzed the dynamic levels of resolvin D1 (RvD1), soluble suppression of tumorigenicity 2 (sST2) and the pan-immune-inflammation value (PIV) in STEMI patients within 24 h of disease onset and their prognostic value. Methods This prospective cohort study enrolled 184 consecutive STEMI patients between December 2023 and December 2024. Serum RvD1 and sST2 levels were measured by enzyme-linked immunosorbent assay at the time of admission (0 h), 6 h post-onset (6 h), and 24 h post-onset (24 h). PIV was derived from routine laboratory data. All patients were followed for 6 months for the occurrence of MACE. Results Dynamic levels of RvD1, sST2, and PIV differed significantly between patients with and without MACE. Multiple logistic regression analysis confirmed that the sST2 level at admission (OR = 1.056, 95% CI: 1.027–1.086), RvD1 level (OR = 0.234, 95% CI: 0.122–0.449) and LnPIV level (OR = 5.139, 95% CI: 1.743–15.154) at 24 h after onset were strong independent risk factors for MACE (all P < 0.001). With the inclusion of the Global Registry of Acute Coronary Events Study (GRACE) score in the risk prediction model, the area under the curve (AUC) increased to 0.826 (95% CI: 0.758–0.890), 0.852 (95% CI: 0.786–0.932), and 0.834 (95% CI: 0.750–0.897). Conclusion Early dynamic changes in RvD1, sST2, and PIV are significantly associated with prognosis in STEMI patients. These biomarkers, particularly sST2 level at admission, RvD1 and LnPIV levels at 24 h after onset, serve as independent predictors for MACE and could improve risk stratification.
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Xu et al. (2025) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=184). LnPIV level at 24 h after onset vs. Lower LnPIV levels was evaluated on Major adverse cardiovascular events (MACE) (OR 5.139, 95% CI 1.743-15.154, p=<0.001). Elevated pan-immune-inflammation value (LnPIV) at 24 hours after symptom onset was a strong independent predictor of major adverse cardiovascular events (OR 5.139) in STEMI patients following PCI.
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