ArticleBMC cardiovascular disorders2026
Early serum TIMP-2 as a biomarker for 90-day chronic kidney disease after percutaneous coronary intervention in ST-elevation myocardial infarction: a prospective cohort study.
Article in BMC cardiovascular disorders, 2026. 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
backgroundContrast-induced acute kidney injury (CI-AKI) remains a concern in patients with ST-elevation myocardial infarction (STEMI) undergoing emergent percutaneous coronary intervention (PCI), but creatinine-based CI-AKI definitions incompletely capture longer-term renal trajectories. Early tubular stress biomarkers such as tissue inhibitor of metalloproteinases-2 (TIMP-2) may provide incremental risk information beyond conventional functional markers.
methodsIn this prospective single-centre cohort, we enrolled 88 consecutive STEMI patients undergoing urgent coronary angiography with or without PCI. Routine laboratory parameters were obtained at admission and 48 h. Serum TIMP-2 was measured 2 h after the procedure using a standardized sandwich ELISA. Early CI-AKI was defined by conventional creatinine-based criteria within 48 h, whereas 90-day chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m² or persistent creatinine elevation at 90 days. We evaluated paired changes, between-group differences by 90-day CKD status, correlations, multivariable linear and logistic regression, and receiver operating characteristic (ROC) discrimination.
resultsEarly CI-AKI occurred in 6/88 patients (6.8%), whereas 90-day CKD was diagnosed in 15/88 (17%), indicating substantial delayed renal dysfunction beyond the 48-h window. The median 2-h serum TIMP-2 concentration was 1.20 ± 0.38 ng/mL. TIMP-2 showed modest correlations with creatinine and urea and remained independently associated with higher 90-day creatinine in multivariable linear regression (B = + 12.0 µmol/L per 1-ng/mL increase; p = 0.016) after adjustment for baseline creatinine and clinical covariates. In parsimonious logistic models, TIMP-2 demonstrated a borderline association with 90-day CKD (odds ratio ≈ 6.38; p = 0.056), while older age was a significant predictor. Standalone ROC discrimination for 90-day CKD was limited (AUC 0.528; 95% confidence interval 0.39-0.65; p = 0.668).
conclusionsIn STEMI patients undergoing emergent angiography/PCI, 90-day CKD was considerably more frequent than early creatinine-defined CI-AKI, underscoring the need for extended renal follow-up. A single 2-hour serum TIMP-2 measurement reflects early tubular stress and independently associates with 90-day creatinine, but offers only modest standalone discrimination for 90-day CKD. TIMP-2 is therefore more likely to have a role within multivariable or biomarker panel-based risk stratification pathways rather than as an isolated classifier.
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