ArticleBMC cardiovascular disorders2025
Dual-pathway model of IL-6 and HSP22/HSP27 dynamics predicts post-PCI MACE in STEMI patients.
Article in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIn patients with STEMI after PCI, an imbalance between the inflammatory response and cellular protective mechanisms is a key factor leading to poor prognosis. The current risk assessment system, which is based on static markers, fails to meet clinical needs. This study aimed to determine a novel dynamic monitoring model that jointly detects the pro-inflammatory cytokine IL-6 and the stress-response proteins HSP22 and HSP27 to optimize risk stratification and prognosis prediction for STEMI patients.
methodsA prospective cohort study design was employed; 176 patients with STEMI and 90 patients with SCHD who underwent emergency PCI from June 2023 and January 2025 were consecutively enrolled. Serum levels of IL-6, HSP22, and HSP27 were measured at baseline and during the periprocedural period (preprocedure, 1/3/4 days postprocedure), and MACE were monitored for 6 months.
objectiveThe predictive efficacy of each marker was evaluated through ROC curve and logistic regression analyses, and a dynamic risk scoring model was established.
resultsThe baseline levels of IL-6 (7.01 ± 2.87 vs. 2.91 ± 1.17 pg/mL), HSP22 (0.591 vs. 0.365 ng/mL), and HSP27 (1.828 vs. 1.090 ng/mL) in the STEMI group were significantly greater than those in the control group (all P < 0.001). The AUCs of each marker for STEMI diagnosis were > 0.9, with HSP27 being the best (AUC = 0.972). Dynamic monitoring revealed characteristic temporal changes: the IL-6 level peaked on the first day after PCI (AUC = 0.785), and the HSP22/HSP27 level peaked on the third day after PCI (AUC = 0.793/0.794). The combined prediction of MACEs by the three markers reached an AUC of 0.875 (sensitivity 70.0%, specificity95.9%), and all were independent predictors.
conclusionThis study confirms that the divergent temporal profiles of IL-6 (the first day after PCI) and HSP22/HSP27 (the third day after PCI) have synergistic predictive value for MACE after PCI. This innovative dynamic monitoring model addresses the key limitations of traditional static detection approaches, offering clinicians a promising tool for potential risk evaluation and guiding prompt therapeutic intervention in STEMI patients. Its clinical significance lies particularly in enhancing early risk stratification, thereby potentially improving patient outcomes.
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