Prognostic significance of suppressor of tumorigenicity 2, endothelin-1, macrophage migration inhibitory factor, interleukin-6 and C-reactive protein in patients with acute myocardial infarction with ST-segment elevation and reduced glomerular filtra

Acute myocardial infarction with ST‑segment elevation (STEMI) is one of the most severe forms of cardiovascular disease, requiring immediate diagnosis and treatment. Prognostic biomarkers play a crucial role in risk stratification and guiding therapeutic strategies in STEMI patients, particularly those with reduced glomerular filtration rate (GFR). Objective — to evaluate the prognostic significance of suppressor of tumorigenicity 2 (ST2), endothelin­1 (ET­1), macrophage migration inhibitory factor (MIF), interleukin­6 (IL­6), and C­reactive protein (CRP) in STEMI patients with reduced GFR compared to those with normal GFR for improved risk stratification and management. Materials and methods. This study was conducted on a cohort of 762 patients diagnosed with STEMI. The mean age of the patients was (60.5±10.5) years, with 74.7% being male. The glomerular filtration rate was calculated using the CKD­EPI 2021 formula. Patients were categorized into two groups: 246 with GFR <60 ml/min/1.73m2 and 516 with GFR ≥60 ml/min/1.73m2. Biomarker levels (ST2, ET­1, MIF, IL­6, CRP) were measured using enzyme­linked immunosorbent assay (ELISA) kits. Results. In patients with reduced GFR, ST2 and CRP levels were significantly higher than in patients with normal GFR (39.48 [26.49—80.71] and 33.78 [21.14—59.66] ng/ml, respectively, p=0.026 and 48 [36—96] and 24 [6—48] mg/l, p=0.015). The levels of MIF and IL‑6 were also increased in patients with reduced GFR, but the differences in these parameters were not statistically significant. No significant difference was recorded in ET‑1 levels between the groups. The analysis of ROC curves for ST2 revealed moderate prognostic accuracy in predicting survival in patients with reduced GFR (AUC=0.659; p=0.016). Conclusions. The results indicate the importance of ST2 as a prognostic marker in STEMI patients with reduced GFR. The use of these biomarkers in clinical practice can improve risk stratification and management in this patient group. Further research is warranted to develop individualized treatment approaches that consider the risks of cardiovascular events and renal dysfunction in STEMI patients.