Prognostic value of β1 adrenergic receptor autoantibodies for microvascular obstruction in patients with STEMI with Post-PCI: A prospective cohort study

IF 4.7 Q2 IMMUNOLOGY

Journal of Translational Autoimmunity Pub Date : 2024-11-14 DOI:10.1016/j.jtauto.2024.100261

Ning Cao , Wenxi Dang , Yanguo Xin , Jiayu Li , Shaohua Guo , Qitian Li , Hui Chen , Shun Li

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Abstract

Backgrounds

Coronary microvascular obstruction (MVO) frequently occurs in patients with ST-segment elevation myocardial infarction (STEMI) following percutaneous coronary intervention (PCI), leading to poor prognosis. β₁ adrenergic receptor autoantibodies (β₁-AA) are present in various cardiovascular diseases and correlate with cardiac damage and dysfunction. However, whether β₁-AA is associated with the occurrence of MVO in patients with STEMI after PCI remains unclear.

Aims

To investigate the prognostic relationship between β₁-AA and the occurrence of MVO in patients with STEMI with post-PCI.

Methods

This prospective study included 403 patients with STEMI who underwent primary PCI. The patients were divided into MVO+ and MVO- groups. Serum β₁-AA levels were measured prior to primary PCI. The primary outcome was MVO, assessed through cardiac magnetic resonance imaging at 5–7 days after PCI.

Results

A total of 127 MVO+ and 276 MVO– patients were identified. Patients with MVO + exhibited higher β₁-AA optical density (OD) compared to MVO- patients. β₁-AA OD, pNT-proBNP, pCK-MB and pTNI were positively associated with MVO following PCI. Notably, the assocition between β₁-AA levels and MVO risk strengthened with increasing pNT-proBNP levels. The combination of β₁-AA, pNT-proBNP and pTNI yielded the most efficient MVO prediction with an area under the ROC curve of 0.87 (95 % CI: 0.83–0.90).

Conclusions

β₁-AA is significantly associated with the occurrence of MVO in STEMI patients following primary PCI. The combination of β₁-AA with pNT-proBNP and pTNI improves predictive accuracy, providing a more robust and effective strategy for assessing MVO risk.

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PCI术后STEMI患者微血管阻塞的β1肾上腺素能受体自身抗体的预后价值：一项前瞻性队列研究

背景经皮冠状动脉介入治疗（PCI）后，ST 段抬高型心肌梗死（STEMI）患者经常会出现冠状动脉微血管阻塞（MVO），导致预后不良。β1肾上腺素能受体自身抗体（β1-AA）存在于各种心血管疾病中，并与心脏损伤和功能障碍相关。目的研究 STEMI 患者接受 PCI 后，β1-AA 与 MVO 发生之间的预后关系。方法这项前瞻性研究纳入了 403 名接受初级 PCI 的 STEMI 患者。将患者分为 MVO+ 组和 MVO- 组。在初级 PCI 之前测量血清 β1-AA 水平。主要结果是通过 PCI 后 5-7 天的心脏磁共振成像评估 MVO。与 MVO- 患者相比，MVO + 患者表现出更高的β1-AA 光密度（OD）。β1-AA OD、pNT-proBNP、pCK-MB 和 pTNI 与 PCI 后的 MVO 呈正相关。值得注意的是，β1-AA 水平与 MVO 风险之间的关联随着 pNT-proBNP 水平的增加而加强。β1-AA、pNT-proBNP 和 pTNI 的组合能最有效地预测 MVO，其 ROC 曲线下面积为 0.87（95 % CI：0.83-0.90）。β1-AA与pNT-proBNP和pTNI的结合提高了预测的准确性，为评估MVO风险提供了一种更稳健、更有效的策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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