Prognostication of Late Cardiac Remodeling in Patients With STEMI Underwent Successful Percutaneous Coronary Intervention: the Role of Macrophage Inhibitory Factor

Abstract

Background: Macrophage inhibitory factor (MIF) plays a pivotal role in late adverse cardiac remodeling in acute ST-segment elevation myocardial infarction (STEMI). The aim of the study was to investigate the predictive role of the circulating MIF in adverse cardiac remodeling in STEMI patients undergoing percutaneous coronary intervention (PCI). Methods: A total of 73 patients with confirmed acute STEMI successfully treated with PCI were enrolled for participation in the study. Control group was included 20 healthy volunteers. All patients signed informed consent to participate in the study. Echo and Doppler, biomarker assay and MIF determinations were performed at baseline and at 6 month after study entry. Results: There were significant differences (P<0.001) between the levels of MIF in control group (573.75 ng/mL; 95% CI = 397.80 to 1016.75 ng/mL) and entire STEMI patient population (2582.80 ng/mL; 95% CI = 1308.40 to 4122.20 ng/mL). The entire STEMI patient population was divided by the median of the MIF level as follow: the first group consisted of STEMI patients with MIF ≤ 2582.80 ng/ mL (n = 36), and the second group consisted of STEMI patients with the levels of MIF > 2582.80 ng/mL (n = 37). We found that cut-off MIF level ≥2644.5 ng/ml at baseline predicted adverse cardiac remodeling (AUC = 0.736, 95% CІ = 0.515 to 0.956, Р=0.0362; sensitivity = 72.7%; specificity = 81.8%; positive predictive value = 52.7%; negative predictive value = 32.4%; positive likelihood ratio = 0.89 and negative likelihood ratio = 0.72). Conclusions: The MIF level ≥2644.5 ng/mL might be predictor for late adverse cardiac remodeling after STEMI.