Using eosinophil response to predict cardiovascular outcomes in patients with ST- elevation myocardial infarction who undergo primary percutaneous coronary intervention

Objective: Eosinophils have been implicated in mediating the inflammatory response after ST-elevation myocardial infarction (STEMI), but its role as a biomarker predicting major adverse cardiovascular events (MACE) remains unclear. We aimed to evaluate the predictive value of eosinophil response on...

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Main Authors: Joyce Lim, Trent Williams, Lucy Murtha, Nishani Mabotuwana, Conagh Kelly, Doan Ngo, Andrew Boyle
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:International Journal of Cardiology. Cardiovascular Risk and Prevention
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772487525000212
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author Joyce Lim
Trent Williams
Lucy Murtha
Nishani Mabotuwana
Conagh Kelly
Doan Ngo
Andrew Boyle
author_facet Joyce Lim
Trent Williams
Lucy Murtha
Nishani Mabotuwana
Conagh Kelly
Doan Ngo
Andrew Boyle
author_sort Joyce Lim
collection DOAJ
description Objective: Eosinophils have been implicated in mediating the inflammatory response after ST-elevation myocardial infarction (STEMI), but its role as a biomarker predicting major adverse cardiovascular events (MACE) remains unclear. We aimed to evaluate the predictive value of eosinophil response on 30-day and 1-year MACE post primary percutaneous coronary intervention (PCI) after STEMI. Methods: Single centre retrospective cohort study of STEMI patients undergoing PCI. Eosinophil response was defined as the change in peripherally circulating eosinophils cell count at admission minus 48 h post primary PCI. Primary endpoints were 30-day and 1-year MACE. Receiver operating characteristic (ROC) curves were created to identify optimal cut-off predicting MACE. Multivariate logistic regression analyses were used to determine if the ROC cut-off was an independent predictor of MACE. Results: Of the 366 patients in this study (median age 61 years [53.0–71.0]; 267 males [73 %]), 41 patients (11.2 %) and 78 patients (21.3 %) developed MACE at 30-days and 1-year. The optimal ROC curve cut-off predicting MACE was an eosinophil response of greater than −0.05 × 10^9/L (ΔEos > −0.05). It had a sensitivity, specificity, and positive and negative predictive value of 83, 39, 6 and 98 % for 30-day MACE, and 74, 39, 19 and 88 % for 1-year MACE. An ΔEos > −0.05 change was associated with a threefold higher likelihood of MACE at 30-days (OR 3.1, 95 % CI 1.04–9.07, p=0.042), but not 1-year Conclusion: An eosinophil response of −0.05 × 10^9L at 48 h following primary PCI post STEMI is highly sensitive at predicting 30-day MACE, and in its absence, holds a high negative predictive value.
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spelling doaj-art-59e7b85a58484879a359faa2bb8b267e2025-08-20T03:09:44ZengElsevierInternational Journal of Cardiology. Cardiovascular Risk and Prevention2772-48752025-06-012520038310.1016/j.ijcrp.2025.200383Using eosinophil response to predict cardiovascular outcomes in patients with ST- elevation myocardial infarction who undergo primary percutaneous coronary interventionJoyce Lim0Trent Williams1Lucy Murtha2Nishani Mabotuwana3Conagh Kelly4Doan Ngo5Andrew Boyle6Heart and Stroke Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia; Corresponding author. C/o College of Health, Medicine and Wellbeing University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.Heart and Stroke Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia; Department of Cardiology, John Hunter Hospital, New Lambton Heights, NSW, AustraliaCollege of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia; Department of Cardiology, John Hunter Hospital, New Lambton Heights, NSW, AustraliaHeart and Stroke Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, AustraliaHeart and Stroke Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, AustraliaHeart and Stroke Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, AustraliaHeart and Stroke Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia; Department of Cardiology, John Hunter Hospital, New Lambton Heights, NSW, AustraliaObjective: Eosinophils have been implicated in mediating the inflammatory response after ST-elevation myocardial infarction (STEMI), but its role as a biomarker predicting major adverse cardiovascular events (MACE) remains unclear. We aimed to evaluate the predictive value of eosinophil response on 30-day and 1-year MACE post primary percutaneous coronary intervention (PCI) after STEMI. Methods: Single centre retrospective cohort study of STEMI patients undergoing PCI. Eosinophil response was defined as the change in peripherally circulating eosinophils cell count at admission minus 48 h post primary PCI. Primary endpoints were 30-day and 1-year MACE. Receiver operating characteristic (ROC) curves were created to identify optimal cut-off predicting MACE. Multivariate logistic regression analyses were used to determine if the ROC cut-off was an independent predictor of MACE. Results: Of the 366 patients in this study (median age 61 years [53.0–71.0]; 267 males [73 %]), 41 patients (11.2 %) and 78 patients (21.3 %) developed MACE at 30-days and 1-year. The optimal ROC curve cut-off predicting MACE was an eosinophil response of greater than −0.05 × 10^9/L (ΔEos > −0.05). It had a sensitivity, specificity, and positive and negative predictive value of 83, 39, 6 and 98 % for 30-day MACE, and 74, 39, 19 and 88 % for 1-year MACE. An ΔEos > −0.05 change was associated with a threefold higher likelihood of MACE at 30-days (OR 3.1, 95 % CI 1.04–9.07, p=0.042), but not 1-year Conclusion: An eosinophil response of −0.05 × 10^9L at 48 h following primary PCI post STEMI is highly sensitive at predicting 30-day MACE, and in its absence, holds a high negative predictive value.http://www.sciencedirect.com/science/article/pii/S2772487525000212EosinophilsST-Elevation myocardial infarctionPrimary percutaneous coronary interventionBiomarkerMajor adverse cardiovascular events
spellingShingle Joyce Lim
Trent Williams
Lucy Murtha
Nishani Mabotuwana
Conagh Kelly
Doan Ngo
Andrew Boyle
Using eosinophil response to predict cardiovascular outcomes in patients with ST- elevation myocardial infarction who undergo primary percutaneous coronary intervention
International Journal of Cardiology. Cardiovascular Risk and Prevention
Eosinophils
ST-Elevation myocardial infarction
Primary percutaneous coronary intervention
Biomarker
Major adverse cardiovascular events
title Using eosinophil response to predict cardiovascular outcomes in patients with ST- elevation myocardial infarction who undergo primary percutaneous coronary intervention
title_full Using eosinophil response to predict cardiovascular outcomes in patients with ST- elevation myocardial infarction who undergo primary percutaneous coronary intervention
title_fullStr Using eosinophil response to predict cardiovascular outcomes in patients with ST- elevation myocardial infarction who undergo primary percutaneous coronary intervention
title_full_unstemmed Using eosinophil response to predict cardiovascular outcomes in patients with ST- elevation myocardial infarction who undergo primary percutaneous coronary intervention
title_short Using eosinophil response to predict cardiovascular outcomes in patients with ST- elevation myocardial infarction who undergo primary percutaneous coronary intervention
title_sort using eosinophil response to predict cardiovascular outcomes in patients with st elevation myocardial infarction who undergo primary percutaneous coronary intervention
topic Eosinophils
ST-Elevation myocardial infarction
Primary percutaneous coronary intervention
Biomarker
Major adverse cardiovascular events
url http://www.sciencedirect.com/science/article/pii/S2772487525000212
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