Prediction of LVAR and MACE in STEMI Though Plasma Multiomics Analysis

Other illness

• Factors affecting blood sampling/exosome/immune/proteome assays:
  • Blood transfusion within 1 month;
  • Known hemolytic disorder;
  • Inadequate venous access.

Lab values

• Severe comorbidities:
  • Prior HF (NYHA ≥II);
  • Severe CKD (eGFR \<30 mL/min/1.73m² or dialysis);
  • Severe liver disease (Child-Pugh B/C);
  • Active malignancy (life expectancy \<1 year);
  • Severe hematologic disorders (thrombocytopenia, coagulopathy, active bleeding).

Other

• Non-atherosclerotic MI: coronary embolism, spasm, aortic dissection, myocarditis, Takotsubo.
• Fibrinolysis-followed-by-PCI.
• Primary PCI complications:
  • No-reflow/slow-flow (final TIMI \<2);
  • Cardiogenic shock or mechanical complication within 7 days;
  • In-hospital repeat revascularization.
• Inability to complete 6-month follow-up.
• Pregnancy or lactation.

• Age ≥18 years and ≤80 years.
• Definite diagnosis of STEMI according to ESC/ACC guidelines:
  • Chest pain lasting \>30 minutes, and
  • ST-segment elevation in at least two contiguous leads: ≥0.2 mV in leads V2-V3 (≥0.2 mV for men, ≥0.15 mV for women) or ≥0.1 mV in other leads, or new-onset left bundle branch block.
• Reperfusion therapy: Symptom onset to first medical contact ≤12 hours, and successful primary PCI (culprit vessel opened, post-procedure TIMI flow grade 3).
• First STEMI (no prior history of myocardial infarction).
• Left ventricular ejection fraction (by echocardiography within 24-48 hours after admission) ≥35%.
• Informed consent: Signed informed consent obtained, with willingness to undergo serial blood sampling and echocardiographic follow-up.