Article Impact Level: HIGH Data Quality: STRONG Summary of Clinical Cardiology, 46(5), 521–528. https://doi.org/10.1002/clc.24005 Dr. Chong Zhang et al.
Points
- Monocytes and fibrinogen (FIB) are critical in driving inflammatory pathways after myocardial infarction (MI), and their interaction is essential.
- The study aimed to determine whether combining FIB levels with a specific monocyte subset (Mon2) can identify MI patients at high risk of future major adverse cardiovascular events (MACEs).
- MI patients were categorized into four groups based on FIB and Mon2 levels, and a median follow-up of 2.7 years was conducted.
- The high FIB/high Mon2 group had the highest risk of MACEs, indicating a potential synergistic role of FIB and Mon2 in predicting adverse cardiovascular outcomes.
- A high FIB level explained 24.9% of the increased risk of MACEs associated with Mon2, suggesting that FIB mediates the association between Mon2 and adverse cardiovascular events.
Summary
In this research paper, the authors investigated the potential synergistic role of fibrinogen (FIB) combined with a specific subset of monocytes (Mon2) in identifying patients at high risk of major adverse cardiovascular events (MACEs) following myocardial infarction (MI). The study focused on the interaction between monocyte subsets and FIB during the inflammatory response after MI. The hypothesis was that combining high FIB levels and elevated Mon2 counts could prioritize patients with increased susceptibility to future MACEs.
The researchers enrolled MI patients who underwent primary percutaneous coronary intervention and categorized them into four groups based on cutoff values for FIB (3.28 g/L) and Mon2 counts (32.20 cells/μL). A median follow-up of 2.7 years was conducted, during which the risk of MACEs in the patient groups was estimated using Kaplan-Meier survival analysis and Cox proportional hazards models. Additionally, mediation analysis was performed to assess the mediating effects of high FIB levels on the association between Mon2 and MACEs.
The results demonstrated that the high FIB/high Mon2 group had the highest risk of MACEs during the median follow-up period. Furthermore, mediation analysis revealed that a high FIB level explained 24.9% (p < .05) of the increased risk of MACEs associated with Mon2.
This study suggests that the combination of FIB and Mon2 may be a potential marker for identifying MI patients at a heightened risk of future MACEs. The findings highlight the translational implications of understanding the synergistic role of FIB and Mon2 in risk stratification and personalized treatment strategies following MI. Further research is warranted to validate these findings and explore potential therapeutic interventions targeting this pathway.
Link to the article: https://onlinelibrary.wiley.com/doi/10.1002/clc.24005
References Zhang, C., Zeng, S., Ji, W., Li, Z., Sun, H., Teng, T., Yu, Y., Zhou, X., & Yang, Q. (2023). Synergistic role of circulating CD14++CD16+ monocytes and fibrinogen in predicting the cardiovascular events after myocardial infarction. Clinical Cardiology, 46(5), 521–528. https://doi.org/10.1002/clc.24005
