Key result
A serum cytokine network comprising IL-17A, VCAM-1, sIL-2R, IL-8, and GATA1 at 24 hours post-pPCI strongly predicted 12-month major adverse cardiac events with an AUC of 0.86.
Why the study?
Inflammation and immune dysregulation after STEMI contribute to adverse remodelling and MACE, prompting investigation into whether serum cytokine networks predict 12-month MACE.
Does a serum cytokine network measured at 24 hours post-pPCI predict 12-month MACE in STEMI patients?
Cohort (n=320)
No
Does a serum cytokine network measured at 24 hours post-pPCI predict 12-month MACE in STEMI patients?
Effect estimate: AUC 0.86 (95% CI 0.81-0.91)
p-value: p=<0.001
A five-cytokine network measured 24 hours after primary PCI robustly predicts 12-month major adverse cardiac events in STEMI patients, outperforming conventional clinical models.
Background: Inflammation and immune dysregulation following ST-elevation myocardial infarction (STEMI) contribute to adverse remodelling and major adverse cardiac events (MACE). This study aimed to identify serum cytokine networks that predict 12-month MACE in STEMI patients, with a focus on IL-17A, VCAM-1, sIL-2R, IL-8, GATA1, IL-3, IL-5, and GM-CSF. Methods: A prospective cohort of 320 STEMI patients undergoing primary percutaneous coronary intervention (pPCI) was enrolled. Serum levels of 18 cytokines, including the eight prespecified markers, were measured at admission, 24 hours, and 72 hours post-pPCI. The primary endpoint was MACE (cardiac death, recurrent MI, heart failure hospitalisation, or target vessel revascularisation) at 12 months. Cytokine networks were analysed using partial correlation matrices and machine learning (LASSO regression). Results: MACE occurred in 71 patients (22.2%). A five-cytokine network comprising IL-17A, VCAM-1, sIL-2R, IL-8, and GATA1 at 24 hours post-pPCI most strongly predicted MACE (AUC 0.86, 95% CI 0.81-0.91). Elevated IL-17A (HR 2.45, p<0.001), VCAM-1 (HR 1.98, p=0.003), and sIL-2R (HR 2.12, p=0.001) were independent predictors. GATA1 was detectable in 62% of patients at 24 hours and correlated with infarct size (r=0.54, p<0.001). IL-3, IL-5, and GM-CSF showed significant univariable associations with MACE, but these associations did not remain independent after multivariable adjustment. Conclusion: A serum cytokine network comprising IL17A, VCAM-1, sIL-2R, IL-8, and GATA1 at 24 hours postpPCI robustly predicts MACE in STEMI. These findings support early immune profiling for risk stratification.
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Liu et al. (2026) conducted a cohort in ST-elevation myocardial infarction (STEMI) (n=320). Five-cytokine network (IL-17A, VCAM-1, sIL-2R, IL-8, GATA1) at 24 hours post-pPCI vs. Clinical model (age, diabetes, Killip class, LVEF) was evaluated on Major adverse cardiac events (MACE) at 12 months (AUC 0.86, 95% CI 0.81-0.91, p=<0.001). A serum cytokine network comprising IL-17A, VCAM-1, sIL-2R, IL-8, and GATA1 at 24 hours post-pPCI strongly predicted 12-month major adverse cardiac events with an AUC of 0.86.
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