Cardiovascular

Temporal Dynamics of Emerging Cardiovascular Biomarkers in the Early Phase After Acute ST-Segment Elevation Myocardial Infarction: A Prospective Single-Center Pilot Study.

Zivkovic S, Misevic V, et al. • Cells • 2026

PubMed 42929840 DOI 10.3390/cells15201868
TL;DR

sST2 and MR-proADM show distinct early post-STEMI kinetics, suggesting potentially informative sampling windows for future prognostic studies, while Gal-3 and GDF-15 showed no significant change over the first 96 h.

Key Findings

Results

Of 46 enrolled STEMI patients, 30 with complete samples at all five time points were analyzed.

  • 16 patients were excluded, mostly due to early discharge.
  • Mean age was 57.9 ± 11.1 years; 66.7% were male.
  • Patients were aged 18-75 years with first STEMI treated with pPCI within 6 h of symptom onset, enrolled between September 2024 and November 2025.
  • Samples were collected at admission and 12 ± 4, 24 ± 4, 48 ± 8, and 96 ± 8 h after pPCI; biomarkers were measured by ELISA.
Results

sST2 showed significant temporal variation after STEMI, with its highest measured concentration at 12 h.

  • The abstract reports significant temporal variation for sST2 (p < 0.001).
  • Highest measured sST2 concentrations occurred at 12 h after pPCI.
Results

MR-proADM showed significant temporal variation after STEMI, with its highest measured concentration at 24 h.

  • The abstract reports significant temporal variation for MR-proADM (p < 0.001).
  • Peak concentrations occurred at 24 h, later than sST2.
Results

The reference marker hs-cTnI also varied significantly over time.

  • hs-cTnI showed significant temporal variation (p < 0.001).
  • It was used as the reference marker of myocardial injury.
Results

Gal-3 and GDF-15 showed no significant change over time during the first 96 h.

  • No significant temporal change was found for either biomarker across the five sampling points.
  • Analysis included 30 patients with complete samples.
Results

In exploratory analyses, sST2 and MR-proADM concentrations were higher in patients with LVEF < 40%.

  • This was a secondary, exploratory objective in a small pilot sample.
  • The authors state larger studies are needed to confirm differences by left ventricular function.
Results

sST2 concentrations were higher in patients with left anterior descending artery (LAD) infarction.

  • This was an exploratory comparison by infarct-related artery.
  • The finding was reported for sST2 specifically in the abstract.
Results

Symptom duration was not associated with biomarker concentrations.

  • Symptom duration was examined as a secondary exploratory variable.
  • Patients were all treated with pPCI within 6 h of symptom onset.
Conclusions

The authors conclude that the distinct kinetics of sST2 and MR-proADM suggest potentially informative sampling windows for future prognostic studies, requiring confirmation in larger studies.

  • The study was a prospective, single-center, exploratory pilot.
  • Larger prospective studies with echocardiographic and clinical follow-up are needed to confirm kinetics and evaluate prognostic value.

What This Means

This small pilot study followed 30 people who had a major type of heart attack (STEMI) and were treated with emergency artery-opening procedures. Researchers took blood samples at admission and up to about four days later to see how four newer heart-related blood markers changed over time, alongside troponin, a standard marker of heart muscle damage. Two markers, sST2 and MR-proADM, rose and fell in clear patterns, with sST2 highest around 12 hours and MR-proADM around 24 hours. The other two, galectin-3 and GDF-15, did not change significantly in this window. In exploratory comparisons, sST2 and MR-proADM were higher in patients whose heart pumping function was notably reduced (LVEF below 40%), and sST2 was higher when the infarct involved the left anterior descending artery. How long symptoms lasted before treatment was not linked to marker levels. This research suggests that the timing of blood sampling may matter when using these markers to judge risk after a heart attack. However, the study was small, from one center, and excluded patients discharged early, so the findings are preliminary. Larger studies that follow patients' heart function and outcomes are needed to know whether these markers can actually predict prognosis.

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Citation

Zivkovic S, Misevic V, Krupnikovic K, Obradovic A, Babic M, Saroskovic B, et al.. (2026). Temporal Dynamics of Emerging Cardiovascular Biomarkers in the Early Phase After Acute ST-Segment Elevation Myocardial Infarction: A Prospective Single-Center Pilot Study.. Cells. https://doi.org/10.3390/cells15201868