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Prolonged Inflammation Associates With Greater Infarct Size and Poor Outcome After ST-Segment Elevation Myocardial Infarction
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DOI：10.1016/j.jacbts.2026.101563.png)
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Abstract
En 中文
• STEMI triggers a rapid systemic inflammatory response, with leukocytes peaking at admission and typically normalizing by days 2 and 3, marking the transition toward inflammation resolution. • A substantial fraction of patients shows nonresolving inflammation, reflected by persistently elevated leukocyte counts at 72 hours after STEMI. • High leukocyte levels on day 3 are linked to larger infarct size by enzymatic markers (peak CK-MB, troponin T) and by 99mTc-sestamibi single-photon emission computed tomography perfusion defect, and to lower LVEF at baseline and follow-up. • Persistent leukocytosis at day 3 identifies a high-risk phenotype with markedly higher 1- and 5-year all-cause mortality; day 3 leukocyte count remains an independent predictor of 1-year mortality in multivariable analysis. • RNA sequencing of human inflammatory monocytes reveals profound, time-dependent transcriptional reprogramming after STEMI.
Keywords:
inflammation
leukocytes
resolution of inflammation
risk stratification
STEMI
BW
body weight
CAD
coronary artery disease
CK-MB
creatine kinase-myocardial band
CMR
cardiac magnetic resonance
CRP
C-reactive protein
DEG
differentially expressed gene
FACS
fluorescence-activated cell sorting
LAD
left anterior descending artery
LVEF
left ventricular ejection fraction
MI
myocardial infarction
PBS
phosphate-buffered saline
PPCI
primary percutaneous coronary intervention
scintiT#d,
scintigraphic tertile at day #
SPECT
single-photon emission computed tomography
STEMI
ST-segment elevation myocardial infarction
T#d,
tertile at day #
Tad
tertile at admission
TCRP
tertile based on peak C-reactive protein
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