Prediction of LVAR and MACE in STEMI Though Plasma Multiomics Analysis
Prediction of Left Ventricular Adverse Remodeling and Major Adverse Cardiovascular Events in Patients With Acute ST-segment Elevation Myocardial Infarction Though Plasma Multiomics Analysis
Beijing Anzhen Hospital
1,000 participants
May 1, 2025
OBSERVATIONAL
Conditions
Summary
To identify plasma multi-omics biomarkers that predict left ventricular adverse remodeling (LVAR) and major adverse cardiovascular events (MACE) in patients with acute ST-segment elevation myocardial infarction, and to investigate the molecular pathways linked to LVAR and MACE.
Eligibility
Inclusion Criteria8
- Age ≥18 years and ≤80 years.
- Definite diagnosis of STEMI according to ESC/ACC guidelines:
- Chest pain lasting >30 minutes, and
- ST-segment elevation in at least two contiguous leads: ≥0.2 mV in leads V2-V3 (≥0.2 mV for men, ≥0.15 mV for women) or ≥0.1 mV in other leads, or new-onset left bundle branch block.
- Reperfusion therapy: Symptom onset to first medical contact ≤12 hours, and successful primary PCI (culprit vessel opened, post-procedure TIMI flow grade 3).
- First STEMI (no prior history of myocardial infarction).
- Left ventricular ejection fraction (by echocardiography within 24-48 hours after admission) ≥35%.
- Informed consent: Signed informed consent obtained, with willingness to undergo serial blood sampling and echocardiographic follow-up.
Exclusion Criteria18
- Non-atherosclerotic MI: coronary embolism, spasm, aortic dissection, myocarditis, Takotsubo.
- Severe comorbidities:
- Prior HF (NYHA ≥II);
- Severe CKD (eGFR <30 mL/min/1.73m² or dialysis);
- Severe liver disease (Child-Pugh B/C);
- Active malignancy (life expectancy <1 year);
- Severe hematologic disorders (thrombocytopenia, coagulopathy, active bleeding).
- Fibrinolysis-followed-by-PCI.
- Primary PCI complications:
- No-reflow/slow-flow (final TIMI <2);
- Cardiogenic shock or mechanical complication within 7 days;
- In-hospital repeat revascularization.
- Inability to complete 6-month follow-up.
- Factors affecting blood sampling/exosome/immune/proteome assays:
- Blood transfusion within 1 month;
- Known hemolytic disorder;
- Inadequate venous access.
- Pregnancy or lactation.
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Interventions
Blood samples were collected from all patients at enrollment (within 24 hours after primary PCI), at days 3-5, and at months 1, 3, and 6 after enrollment. Echocardiography was performed at enrollment (baseline, within 24-48 hours after admission), and at months 1, 3, and 6 after enrollment.
Locations(1)
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NCT06885619