Prognostic value of the Stanniocalcin-2/PAPP-A/IGFBP-4 axis in ST-segment elevation myocardial infarction
Male
0301 basic medicine
Stanniocalcin-2
Time Factors
Patient Readmission
STEMI
03 medical and health sciences
Percutaneous Coronary Intervention
0302 clinical medicine
Predictive Value of Tests
Risk Factors
Cause of Death
Diseases of the circulatory (Cardiovascular) system
Humans
Pregnancy-Associated Plasma Protein-A
Prospective Studies
10. No inequality
Original Investigation
Aged
Glycoproteins
Aged, 80 and over
Heart Failure
Middle Aged
Prognosis
IGFBP-4
3. Good health
Insulin-Like Growth Factor Binding Protein 4
RC666-701
Intercellular Signaling Peptides and Proteins
ST Elevation Myocardial Infarction
Female
PAPP-A
Biomarkers
DOI:
10.1186/s12933-018-0710-3
Publication Date:
2018-04-30T05:14:17Z
AUTHORS (12)
ABSTRACT
The aim of the present study was to evaluate the prognostic value of the Stanniocalcin-2/PAPP-A/IGFBP-4 axis in patients with ST-segment elevation myocardial infarction (STEMI).Observational cohort study performed in 1085 consecutive STEMI patients treated with early reperfusion between February 2011 and August 2014. Stanniocalcin-2, PAPP-A, and IGFBP-4 were measured using state-of-the art immunoassays. The primary outcome was the composite endpoint of all-cause mortality and readmission due to heart failure (HF).Median follow-up was 3.3 years (IQR 1.0-3.7), during which 176 patients (16.2%) presented a composite endpoint. Multivariable cox regression analysis revealed that Stanniocalcin-2 (HR 2.06; 95% CI 1.13-3.75; p = 0.018), IGFBP-4 (HR 1.73; 95% CI 1.14-2.64; p = 0.010), Killip-Kimball class III-IV (HR 1.40; 95% CI 1.13-1.74; p = 0.002), NT-ProBNP (HR 1.21; 95% CI 1.07-1.37; p = 0.002), age (HR 1.06; 95% CI 1.04-1.08; p < 0.001) and left ventricular ejection fraction (HR 0.97; 95% CI 0.95-0.98; p < 0.001) were independent predictors of the composite endpoint. A model containing Stanniocalcin-2 and IGFBP-4 on top of clinical variables significantly improved C-index discrimination (p = 0.036). Stanniocalcin-2 was also identified as independent predictor of all-cause mortality (HR 2.23; 95% CI 1.16-4.29; p = 0.017) and readmission due to HF (HR 3.42; 95% CI 1.22-9.60; p = 0.020).In STEMI patients, Stanniocalcin-2 and IGFBP-4 emerged as independent predictors of all-cause death and readmission due to HF. The Stanniocalcin-2/PAPP-A/IGFBP-4 axis exhibits a significant role in STEMI risk stratification.
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