Liu-Chang Zheng,1 Fang Liu,2 Pei-Ming Zheng,1 Zheng Xiao,1 Fa-Cai Cui1 

1Department of Clinical Laboratory, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China; 2Department of Medical Imaging, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China

Correspondence: Liu-Chang Zheng, Email zhengliuchang1512@163.com

Objective: Acute myocardial infarction (AMI) in the elderly is associated with high morbidity and mortality, with major adverse cardiovascular events (MACE) remaining a major concern despite early revascularization. This study aimed to evaluate the association of soluble suppression of tumorigenicity 2 (sST2), interleukin-33 (IL-33), and homocysteine (Hcy) with coronary stenosis severity and their predictive value for MACE in elderly AMI patients.
Methods: A retrospective analysis was conducted on 143 elderly AMI patients (≥ 65 years) admitted between June 2022 and June 2024. Patients were divided into two groups based on MACE occurrence: Group A (no MACE, n=56) and Group B (MACE, n=87). Serum sST2, IL-33, and Hcy levels were measured using ELISA, and coronary stenosis severity was assessed using the Gensini score. Statistical analyses included Spearman correlation, multivariate logistic regression, and receiver operating characteristic (ROC) curve analysis to evaluate predictive performance.
Results: Serum sST2, IL-33, and Hcy levels were significantly higher in the MACE group compared to the non-MACE group (72.37± 10.68 vs 38.76± 11.15, p< 0.05; 60.61± 10.89 vs 33.74± 11.23, p< 0.05; 32.76± 4.15 vs 15.38± 4.62, p< 0.05, respectively). Biomarker levels positively correlated with coronary stenosis severity (sST2: r=0.647, p< 0.05; IL-33: r=0.659, p< 0.05; Hcy: r=0.582, p< 0.05). Multivariate logistic regression confirmed that sST2 (OR=1.056, 95% CI: 1.015– 1.094, p=0.005), IL-33 (OR=1.069, 95% CI: 1.024– 2.016, p=0.001), and Hcy (OR=1.037, 95% CI: 1.008– 1.077, p=0.033) were independent risk factors for MACE. ROC analysis showed that sST2, IL-33, and Hcy had AUCs of 0.841 (95% CI: 0.762– 0.915, p< 0.001), 0.803 (95% CI: 0.724– 0.878, p< 0.001), and 0.729 (95% CI: 0.642– 0.812, p< 0.001), respectively. Combined detection of all three biomarkers significantly improved MACE prediction (AUC=0.910, 95% CI: 0.851– 0.956, p< 0.001).
Conclusion: Serum sST2, IL-33, and Hcy levels are positively correlated with coronary stenosis severity and independently associated with MACE in elderly AMI patients. Their combined detection significantly enhances MACE prediction, providing a potential strategy for improved risk stratification and management in this high-risk population.

Keywords: acute myocardial infarction, sST2, IL-33, Hcy, MACE, predictive value