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

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 20...

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Detalles Bibliográficos
Autores: Cediel, Germán|||0000-0001-9667-7507, Rueda, Ferran|||0000-0001-5464-4870, Oxvig, Claus, Oliveras, Teresa, Labata, Carlos|||0000-0002-4505-0787, De Diego, Oriol|||0000-0002-8476-7094, Ferrer Massot, Marc|||0000-0003-0046-1301, Aranda-Nevado, M. Cruz, Serra-Gregori, Judith, Núñez, Julio|||0000-0003-1672-7119, Garcia Garcia, Cosme|||0000-0001-6330-1677, Bayés-Genís, Antoni|||0000-0002-3044-197X
Tipo de recurso: artículo
Fecha de publicación:2018
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:190801
Acceso en línea:https://ddd.uab.cat/record/190801
https://dx.doi.org/urn:doi:10.1186/s12933-018-0710-3
Access Level:acceso abierto
Palabra clave:STEMI
Prognosis
Stanniocalcin-2
PAPP-A
IGFBP-4
Descripción
Sumario: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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