Circulating Sulfatide, A Novel Biomarker for ST-Segment Elevation Myocardial Infarction

Aims: ST-segment elevation myocardial infarction (STEMI) is an acute inflammatory and thrombotic disease due to coronary artery atherosclerotic lesions. Studies have established the correlation of serum sulfatides with inflammation, thrombogenesis, and atherosclerosis. We observed that serum sulfatides level significantly increased in STEMI patients. In this study, we try to identify the relationship of serum sulfatides level on clinical outcomes of patients in STEMI. Methods: Serum sulfatides level was monitored in 370 inpatients within 24 h of STEMI onset. On the basis of the level of serum sulfatides that was below 10 mu mol/L in the normal population, the patients were divided into two groups with the median value of 15.2 mu mol/L; low sulfatide group [serum sulfatides level <= 15.2 mu mol/L (n=200)] and high sulfatide group [serum sulfatides level >15.2 mu mol/L (n=170)]. Patients' baseline characteristics, in-hospital outcomes, and late major adverse cardiovascular events (MACE) were analyzed. Independent incident for in-hospital death and late adverse events were modeled by multivariate logistic and Cox regression analysis. Results: Between the two groups, there were no differences in the angiographic characteristics, percutaneous coronary intervention (PCI) results, and in-hospital recovery. However, high serum sulfatides level is positively correlated with increased rate of in-hospital death (OR 0.971; 95% CI 0.926-0.990, p=0.019). In addition, this group of patients has more cumulative incidences of target vessel revascularization (TVR) (23% vs. 8%, p<0.05) and increased overall MACE (28% vs. 10%, p<0.05). Cox regression analysis indicated that high serum sulfatides level contributes to TVR and overall MACE. Conclusions: Elevated serum sulfatides level positively correlate with in-hospital death and complications (TVR and MACE) in STEMI patients.