Prognostic value of the Stanniocalcin-2/PAPP-A/IGFBP-4 axis in ST-segment elevation myocardial infarction

• DOI: 10.1186/s12933-018-0710-3
• Publication Date: 2018-04-30T05:14:17Z
• Authors: Germán Cediel; Ferran Rueda; Claus Oxvig; Teresa Oliveras; Carlos Labata; Oriol de Diego; Marc Ferrer; M. Cruz Aranda-Ne...; Judith Serra-Gregori; Julio Núñez; Cosme García; Antoni Bayes-Genis
• Keywords: 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

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.