Document Type
Article
Publication Date
2-3-2025
Abstract
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 (/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.
Recommended Citation
Ma, Jie; Ma, Ke; Chen, Jing; Yang, Xinying; Gao, Fei; Gao, Hai; Zhang, Hui; Ma, Xin-Liang; Du, Jie; Li, Ping; and Li, Yulin, "Development and Validation of Risk Stratification for Heart Failure After Acute Coronary Syndrome Based on Dynamic S100A8/A9 Levels" (2025). Department of Emergency Medicine Faculty Papers. Paper 258.
https://jdc.jefferson.edu/emfp/258
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
PubMed ID
39895550
Language
English
Included in
Biological Factors Commons, Cardiovascular Diseases Commons, Emergency Medicine Commons, Investigative Techniques Commons, Pathological Conditions, Signs and Symptoms Commons
Comments
This article is the author's final published version in Journal of the American Heart Association, Volume 14, Issue 3, February 2025, Article number e037401.
The published version is available at https://doi.org/10.1161/JAHA.124.037401.
Copyright © 2025 The Author(s)