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.