Prognostic value of β1 adrenergic receptor autoantibodies for microvascular obstruction in patients with STEMI with Post-PCI: A prospective cohort study

Abstract

Backgrounds: Coronary microvascular obstruction (MVO) frequently occurs in patients with ST-segment elevation myocardial infarction (STEMI) following percutaneous coronary intervention (PCI), leading to poor prognosis. β1 adrenergic receptor autoantibodies (β1-AA) are present in various cardiovascular diseases and correlate with cardiac damage and dysfunction. However, whether β1-AA is associated with the occurrence of MVO in patients with STEMI after PCI remains unclear. Aims: To investigate the prognostic relationship between β1-AA and the occurrence of MVO in patients with STEMI with post-PCI. Methods: This prospective study included 403 patients with STEMI who underwent primary PCI. The patients were divided into MVO+ and MVO- groups. Serum β1-AA levels were measured prior to primary PCI. The primary outcome was MVO, assessed through cardiac magnetic resonance imaging at 5–7 days after PCI. Results: A total of 127 MVO+ and 276 MVO– patients were identified. Patients with MVO + exhibited higher β1-AA optical density (OD) compared to MVO- patients. β1-AA OD, pNT-proBNP, pCK-MB and pTNI were positively associated with MVO following PCI. Notably, the assocition between β1-AA levels and MVO risk strengthened with increasing pNT-proBNP levels. The combination of β1-AA, pNT-proBNP and pTNI yielded the most efficient MVO prediction with an area under the ROC curve of 0.87 (95 % CI: 0.83–0.90). Conclusions: β1-AA is significantly associated with the occurrence of MVO in STEMI patients following primary PCI. The combination of β1-AA with pNT-proBNP and pTNI improves predictive accuracy, providing a more robust and effective strategy for assessing MVO risk.

Keywords

• β1 adrenergic receptor autoantibodies
• Microvascular obstruction
• Acute myocardial infarction
• Percutaneous coronary intervention
• Cardiovascular magnetic resonance