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Trajectories of Circulating Monocyte Subsets After ST-Elevation Myocardial Infarction During Hospitalization: Latent Class Growth Modeling for High-Risk Patient Identification

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Abstract

It remains unclear if the developmental trajectories of a specific inflammatory biomarker during the acute phase of ST-elevation myocardial infarction (STEMI) provide outcome prediction. By applying latent class growth modeling (LCGM), we identified three distinctive trajectories of CD14++CD16+ monocytes using serial flow cytometry assays from day 1 to day 7 of symptom onset in 96 de novo STEMI patients underwent primary percutaneous coronary intervention. Membership in the high-hump-shaped trajectory (16.8%) independently predicted adverse cardiovascular outcomes during a median follow-up of 2.5 years. Moreover, inclusion of CD14++CD16+ monocyte trajectories significantly improved area under the curve (AUC) when added to left ventricular ejection fraction-based prediction model (ΔAUC = 0.093, P = 0.013). Therefore, CD14++CD16+ monocyte trajectories during STEMI hospitalization are a novel risk factor for post-STEMI adverse outcomes. These results provide the first proof-of-principle evidence in support of the risk stratification role of LCGM-based longitudinal modeling of specific inflammatory markers during acute STEMI.

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Abbreviations

BP:

Blood pressure

CHD:

Coronary heart disease

CI:

Confidence interval

FCM:

Flow cytometry

FMO:

Fluorescence Minus One

HR:

Hazard ratio

LCGM:

Latent class growth modeling

LVEF:

Left ventricular ejection fraction

MACE:

Major adverse cardiovascular events

MI:

Myocardial infarction

OR:

Odds ratio

PCI:

Percutaneous coronary intervention

ROC:

Receiver operator characteristic curve

STEMI:

ST-elevation myocardial infarction

WBC:

White blood cell

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Funding

This work was supported by the National Natural Science Foundation of China (81570335) and Intra-mural research grants from Pingjin Hospital (FYZ201402, FYZ201605).

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Author notes

  1. Shan Zeng and Li-Fang Yan contributed equally to this work.

Authors and Affiliations

  1. Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Center, 220, Chenglin Street, Dongli District, Tianjin, 300162, China

    Shan Zeng, Li-Fang Yan, Yan-Wei Luo, Xin-Lin Liu, Jun-Xiang Liu, Zhao-Zeng Guo, Zhong-Wei Xu, Yu-Ming Li & Xin Zhou

  2. Department of Respiratory and Critical Care Medicine, Pingjin Hospital, 220, Chenglin Street, Dongli District, Tianjin, 300162, China

    Wen-Jie Ji

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  1. Shan Zeng
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Correspondence to Wen-Jie Ji or Xin Zhou.

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Ethical Approval

This study was approved by the Ethical Committee of Pingjin Hospital and performed in accordance with the Declaration of Helsinki.

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Informed written consent was obtained from all participants for being included in the study.

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Zeng, S., Yan, LF., Luo, YW. et al. Trajectories of Circulating Monocyte Subsets After ST-Elevation Myocardial Infarction During Hospitalization: Latent Class Growth Modeling for High-Risk Patient Identification. J. of Cardiovasc. Trans. Res. 11, 22–32 (2018). https://doi.org/10.1007/s12265-017-9782-9

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