ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Coronary Artery Disease
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1591578
Prediction of long-term major adverse cardiac events after myocardial infarction: value of combination of inflammatory biomarkers and GRACE score
Provisionally accepted
- 1Zhongshan Hospital, Fudan University, Shanghai, China
- 2Second Affiliated Hospital of Naval Medical University, Shanghai, China
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Objective: This study aims to investigate the prognostic value of integrating inflammatory biomarkers with the established Global Registry of Acute Coronary Events (GRACE) risk score for predicting clinical outcomes in patients with myocardial infarction (MI).This prospective, single-center study enrolled adult MI patients admitted to the coronary care unit Zhongshan Hospital, Fudan University. Blood samples were collected to measure inflammatory markers (IL-1β, sIL-2R, IL-6, IL-8), and myocardial biomarkers. The Gensini score and GRACE score was calculated for each patient. The primary endpoint was the post-MI occurrence of a composite of major adverse cardiovascular events (MACE), including cardiovascular death, non-fatal MI, and nonfatal ischemic stroke. Predictive performance of biomarkers was evaluated using Kaplan-Meier survival curves, Cox regression analysis, and receiver operating characteristic (ROC) curves.Results: A total of 724 patients (median age 64 years, 85.0% male) were included with a median follow-up of 1.7 years. During follow-up, 81 patients (11.1%) experienced MACE, including 45 cardiovascular deaths, 23 MIs, and 13 strokes. Multivariate Cox regression analysis revealed that sIL-2R and IL-8 were independent predictors of MACE. Elevated levels of sIL-2R (HR = 9.123, 95% CI: 5.883 -14.147, p < 0.001) and IL-8 (HR = 4.443, 95% CI: 2.769 -7.131, p < 0.001) were significantly associated with an increased risk of MACE. After adjustment for cardiovascular risk factors, elevated sIL-2R (adjusted HR: 3.761, 95% CI: 2.269 -6.233, p < 0.001) and IL-8 (adjusted HR: 2.294, 95% CI: 1.375 -3.825, p = 0.001) levels remained significantly associated with an increased risk of MACE. The combination of sIL-2R, IL-8, and GRACE score displayed effective predictive performance for long-term MACE, as evidenced by ROC curve analysis (AUC = 0.824, 95% CI: 0.775 -0.873, p < 0.001).Elevated levels of sIL-2R and IL-8 independently predict increased risk of MACE in MI patients. Importantly, the integration of biomarkers such as sIL-2R and IL-8 with the GRACE score can significantly improve predictive performance, offering a robust approach for risk stratification in MI patients.
Keywords: GRACE score, Soluble interleukin-2 receptor, Interleukin-8, Major adverse cardiovascular events, Myocardial Infarction
Received: 11 Mar 2025; Accepted: 27 Jun 2025.
Copyright: © 2025 Tian, Yu, Mao, Li, Liu, Xu, Huang, Lv and Pan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Qianzhou Lv, Zhongshan Hospital, Fudan University, Shanghai, China
Kunming Pan, Zhongshan Hospital, Fudan University, Shanghai, China
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