AIM: The aim of the study was to determine the predictive possibility of the GDF-15 marker in the stratification of the ACS complications risk within 5 years after the event.

MATERIALS AND METHODS: 70 patients with ACS were involved. The mean age was (61.8 +/- 1.3) years, the following diagnosis was established in the patients: 76 patients had acute myocardial infarction with Q (AMI with Q), 28 - acute myocardial infarction without Q (AMI without Q) and 36 patients were diagnosed unstable angina (UA). During the follow-up period the endpoint was reached by 28 patients.

RESULTS: A statistical relationship between the elevated level of GDF - 15 and the 5-year survival of these patients (χ2 = 4.75, p = 0.03) has been found. It was established that the level of the GDF-15 biomarker > 2350 pg/ml independently predicted the onset of adverse events with the sensitivity of 80% and the specificity of 60% (p = 0.006). To investigate the influence of the GDF-15 levels on mortality in the remote period, the Cox regression analysis was performed. It was revealed that the level of GDF-15 significantly predicted the onset of the primary endpoint within 5 years after ACS (p = 0.004).

PATIENTS AND METHODS: Materials and methods: The study included 165 patients admitted with STEMI within 12 hours of the onset of symptoms be¬tween January 2020 and August 2021. All patients underwent primary PCI according to the guidelines, followed by standard examination and treatment at the hospital. Blood samples for biomarker analysis (MMP-9, cTnI) and other routine tests were taken on admission. At six months after the event, all patients underwent clinical follow-up. Patients were contacted either by phone, through family members or their physicians 1 year after the event.

RESULTS: Results: The composite endpoint reached 9% of patients at one-year follow-up. ROC analysis of MMP-9 with the one-year com¬posite endpoint showed an AUC=0.711, with 91.7% sensitivity, and 47.4% specificity, 95% CI - 0.604 to 0.802, p=0.0037. ROC analysis of EQ-5D questionnaire with the one-year composite endpoint showed AUC = 0.73, the 95% CI - 0.624 to 0.820, p< 0.0195, with sensitivity 54.5% and specificity 94.7%. A logistic regression model showed a statistical association with the com¬posite endpoint at one year after STEMI in both EQ-5D (OR=0.89, 95% CI: 0.8313- 0.9725, p=0.0079) and MMP-9 (OR=1.0151, 95% CI:1.0001-1.0304, p=0.0481).

PATIENTS AND METHODS: Materials and methods: The study involved 134 ST-segment elevation myocardial infarction patients. Occurrence of post-percutaneous coronary (PCI) intervention epicardial blood flow of TIMI <3 or myocardial blush grade 0-1 along with ST resolution <70% within 2 hours after PCI was qualified as the no-reflow condition. Left ventricle remodeling was defined after 6-months as an increase in left ventricle end-diastolic volume and/or end-systolic volume by more than 10%.

RESULTS: Results: A logistic regression formula was evaluated. Included biomarkers were macrophage migration inhibitory factor and sST2, left ventricle ejection fraction: Y=exp(-39.06+0.82EF+0.096ST2+0.0028MIF) / (1+exp(-39.06+0.82EF+0.096ST2+0.0028MIF)). The estimated range is from 0 to 1 point. Less than 0.5 determines an adverse outcome, and more than 0.5 is a good prognosis. This equation, with sensitivity of 77 % and specificity of 85%, could predict the development of adverse left ventricle remodeling six months after a coronary event (AUC=0.864, CI 0.673 to 0.966, p<0.05).