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Background <p>In 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.</p> Methods <p>A 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.</p> Objective <p>The predictive efficacy of each marker was evaluated through ROC curve and logistic regression analyses, and a dynamic risk scoring model was established.</p> Results <p>The 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 <i>P</i> &lt; 0.001). The AUCs of each marker for STEMI diagnosis were &gt; 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.</p> Conclusion <p>This 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.</p>

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Dual-pathway model of IL-6 and HSP22/HSP27 dynamics predicts post-PCI MACE in STEMI patients

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月11日

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  • Yaning Hu,
  • Yuansheng Liu,
  • Yueping Wang,
  • Fengxu Lin,
  • Ronghong Chen,
  • Chuanjun Chen,
  • Tao Qu

摘要

Background

In 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.

Methods

A 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.

Objective

The predictive efficacy of each marker was evaluated through ROC curve and logistic regression analyses, and a dynamic risk scoring model was established.

Results

The 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.

Conclusion

This 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.