Development and Validation of Risk Stratification for Heart Failure After Acute Coronary Syndrome Based on Dynamic S100A8/A9 Levels
Background The early assessment of heart failure (HF) risk in patients with acute coronary syndrome (ACS) can help reduce mortality. S100A8/A9 is not only rapidly released after myocardial ischemia, but is also involved in reperfusion injury, which is an important predictor of HF after ACS. We attem...
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| Format: | Article |
| Language: | English |
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Wiley
2025-02-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.037401 |
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| author | Jie Ma Ke Ma Jing Chen Xinying Yang Fei Gao Hai Gao Hui Zhang Xin‐Liang Ma Jie Du Ping Li Yulin Li |
| author_facet | Jie Ma Ke Ma Jing Chen Xinying Yang Fei Gao Hai Gao Hui Zhang Xin‐Liang Ma Jie Du Ping Li Yulin Li |
| author_sort | Jie Ma |
| collection | DOAJ |
| description | Background The early assessment of heart failure (HF) risk in patients with acute coronary syndrome (ACS) can help reduce mortality. S100A8/A9 is not only rapidly released after myocardial ischemia, but is also involved in reperfusion injury, which is an important predictor of HF after ACS. We attempted to construct a reliable HF risk stratification tool for evaluating patients with ACS after reperfusion therapy based on S100A8/A9 dynamic changes. Methods and Results This prospective study included 3 independent cohorts of patients with ACS who received reperfusion therapy. The discovery cohort was divided into 2 subgroups: the longitudinal subgroup (n=264) with serum S100A8/A9 levels measured at admission and on days 1, 2, 3, and 4 postadmission, respectively, and the 2‐point subgroup (n=798) with S100A8/A9 levels measured at admission and on day 1 postadmission, respectively. Validation cohorts 1 (n=1399) and 2 (n=1183) both had S100A8/A9 levels measured on day 1 postadmission. HF events included in‐hospital HF events after the initial presentation and long‐term HF events after discharge. The median follow‐up for the discovery cohort, validation cohort 1, and validation cohort 2 was 4.2, 2.6, and 1.8 years, respectively. In the discovery cohort, S100A8/A9's predictive ability at day 1 surpassed other time points. Through the S100A8/A9‐guided risk stratification, patients deemed high risk (>7900 ng/mL) exhibited a higher 1‐year HF event rate (46% versus 2%, 38% versus 5%) than patients at low risk (<2100 ng/mL) in both validation cohorts. Among patients without left ventricular dysfunction after ACS, β‐blocker therapy correlated with reduced 1‐year HF events in intermediate‐to‐ high‐risk patients but not in low‐risk patients. Conclusions S100A8/A9 levels on day 1 accurately classified patients at varying risks of HF, serving as a robust tool for HF risk prediction and treatment guidance. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03752515. |
| format | Article |
| id | doaj-art-6caab9b1da7c41dea467589b3553aae5 |
| institution | Kabale University |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-6caab9b1da7c41dea467589b3553aae52025-02-04T11:00:01ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-02-0114310.1161/JAHA.124.037401Development and Validation of Risk Stratification for Heart Failure After Acute Coronary Syndrome Based on Dynamic S100A8/A9 LevelsJie Ma0Ke Ma1Jing Chen2Xinying Yang3Fei Gao4Hai Gao5Hui Zhang6Xin‐Liang Ma7Jie Du8Ping Li9Yulin Li10Beijing Anzhen Hospital of Capital Medical University Beijing ChinaBeijing Anzhen Hospital of Capital Medical University Beijing ChinaBeijing Anzhen Hospital of Capital Medical University Beijing ChinaBeijing Anzhen Hospital of Capital Medical University Beijing ChinaBeijing Anzhen Hospital of Capital Medical University Beijing ChinaBeijing Anzhen Hospital of Capital Medical University Beijing ChinaDepartment of Preventive Medicine, Feinberg School of Medicine Northwestern University Chicago IL USADepartment of Emergency Medicine Thomas Jefferson University Philadelphia PA USABeijing Anzhen Hospital of Capital Medical University Beijing ChinaBeijing Anzhen Hospital of Capital Medical University Beijing ChinaBeijing Anzhen Hospital of Capital Medical University Beijing ChinaBackground The early assessment of heart failure (HF) risk in patients with acute coronary syndrome (ACS) can help reduce mortality. S100A8/A9 is not only rapidly released after myocardial ischemia, but is also involved in reperfusion injury, which is an important predictor of HF after ACS. We attempted to construct a reliable HF risk stratification tool for evaluating patients with ACS after reperfusion therapy based on S100A8/A9 dynamic changes. Methods and Results This prospective study included 3 independent cohorts of patients with ACS who received reperfusion therapy. The discovery cohort was divided into 2 subgroups: the longitudinal subgroup (n=264) with serum S100A8/A9 levels measured at admission and on days 1, 2, 3, and 4 postadmission, respectively, and the 2‐point subgroup (n=798) with S100A8/A9 levels measured at admission and on day 1 postadmission, respectively. Validation cohorts 1 (n=1399) and 2 (n=1183) both had S100A8/A9 levels measured on day 1 postadmission. HF events included in‐hospital HF events after the initial presentation and long‐term HF events after discharge. The median follow‐up for the discovery cohort, validation cohort 1, and validation cohort 2 was 4.2, 2.6, and 1.8 years, respectively. In the discovery cohort, S100A8/A9's predictive ability at day 1 surpassed other time points. Through the S100A8/A9‐guided risk stratification, patients deemed high risk (>7900 ng/mL) exhibited a higher 1‐year HF event rate (46% versus 2%, 38% versus 5%) than patients at low risk (<2100 ng/mL) in both validation cohorts. Among patients without left ventricular dysfunction after ACS, β‐blocker therapy correlated with reduced 1‐year HF events in intermediate‐to‐ high‐risk patients but not in low‐risk patients. Conclusions S100A8/A9 levels on day 1 accurately classified patients at varying risks of HF, serving as a robust tool for HF risk prediction and treatment guidance. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03752515.https://www.ahajournals.org/doi/10.1161/JAHA.124.037401acute coronary syndromeheart failureS100A8/A9β‐blocker |
| spellingShingle | Jie Ma Ke Ma Jing Chen Xinying Yang Fei Gao Hai Gao Hui Zhang Xin‐Liang Ma Jie Du Ping Li Yulin Li Development and Validation of Risk Stratification for Heart Failure After Acute Coronary Syndrome Based on Dynamic S100A8/A9 Levels Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease acute coronary syndrome heart failure S100A8/A9 β‐blocker |
| title | Development and Validation of Risk Stratification for Heart Failure After Acute Coronary Syndrome Based on Dynamic S100A8/A9 Levels |
| title_full | Development and Validation of Risk Stratification for Heart Failure After Acute Coronary Syndrome Based on Dynamic S100A8/A9 Levels |
| title_fullStr | Development and Validation of Risk Stratification for Heart Failure After Acute Coronary Syndrome Based on Dynamic S100A8/A9 Levels |
| title_full_unstemmed | Development and Validation of Risk Stratification for Heart Failure After Acute Coronary Syndrome Based on Dynamic S100A8/A9 Levels |
| title_short | Development and Validation of Risk Stratification for Heart Failure After Acute Coronary Syndrome Based on Dynamic S100A8/A9 Levels |
| title_sort | development and validation of risk stratification for heart failure after acute coronary syndrome based on dynamic s100a8 a9 levels |
| topic | acute coronary syndrome heart failure S100A8/A9 β‐blocker |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.037401 |
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