Apoptotic markers and Dectin-1+ cells predict cardiac function in patients with ST-elevation myocardial infarction after percutaneous coronary intervention: a retrospective cohort study

BACKGROUND: To investigate the prognostic value of apoptotic markers and dendritic cell-associated C-type lectin-1 (Dectin-1)-positive cells on cardiac function in patients with ST-elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI). METHODS: Patients with STEMI who underwent successful PCI at Wuhan Hospital of Traditional Chinese Medicine from March 2019 to June 2022 were retrospectively analyzed. Patients were divided into two groups based on whether left ventricular ejection fraction (LVEF) improved < 10% (the LVEF non-improvement group) or ≥ 10% (the LVEF improvement group) at 30 days post-PCI compared to that at 24 h after PCI. Blood test results, imaging measurements, apoptotic markers, and soluble Dectin-1 level were compared between the two groups. Multivariable logistic regression was performed adjusting for age, sex, diabetes, and LAD occlusion rate. RESULTS: Among 96 patients included, 28 showed LVEF improvement. Compared to that in the LVEF non-improvement group, the expression levels of tumor necrosis factor-like weak inducer of apoptosis (TWEAK) and Dectin-1 were significantly lower in the LVEF improvement group (P < 0.05), while the expression level of tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) was significantly higher in the LVEF improvement group (P < 0.05). TRAIL (P = 0.047) and TWEAK (P = 0.005) were independently associated with LVEF improvement after adjusting for confounders. TRAIL, TWEAK, soluble Dectin-1, and a combination of these three biomarkers exhibited prediction sensitivity for LVEF improvement in post-PCI patients with STEMI of 50.00%, 60.71%, 67.86%, 78.57%, respectively, and specificity of 79.41%, 73.53%, 57.35%, 82.35%, respectively. CONCLUSIONS: Apoptotic markers and soluble Dectin-1 may serve as potential predictors of cardiac function recovery in patients with STEMI following PCI, and the combination of these markers showed improved prognostic value, though further validation in larger, prospective cohorts is warranted.