# Predictive value of HPSE for major adverse cardiovascular events in patients with ST-segment elevation myocardial infarction

## TL;DR

High levels of HPSE in coronary blood predict major cardiovascular events in patients with heart attacks, improving risk assessment.

## Contribution

HPSE is shown as an independent predictor of MACE in STEMI patients, enhancing the GRACE score's predictive power.

## Key findings

- STEMI patients with MACE had significantly higher coronary HPSE levels (5.08 ng/mL vs. 3.68 ng/mL).
- HPSE remained an independent predictor of MACE after adjusting for risk factors (HR = 1.693).
- Combining HPSE with the GRACE score improved MACE prediction (AUC = 0.849).

## Abstract

Although early mortality rates have decreased following reperfusion therapies such as percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI), they remain at risk for major adverse cardiovascular events (MACE). Heparanase (HPSE) is an endogenous β-D-glucuronosidase and plays a key role in inflammation and vascular remodeling. This study investigated the predictive value of HPSE for MACE after STEMI.

This prospective observational study included 207 consecutive STEMI patients who received primary PCI. Coronary blood was collected 10 min after balloon dilation. Coronary HPSE levels were measured by enzyme-linked immunosorbent assay (ELISA). Patients were followed for 6 months to record the occurrence of MACE.

During the 6-month follow-up period, 53 patients (25.6%) experienced MACE. Patients who experienced MACE had significantly higher coronary HPSE levels than those without (5.08 ± 1.27 ng/mL vs. 3.68 ± 1.20 ng/mL, P < 0.001). In multivariate Cox regression analysis, after adjusting for established risk factors, elevated HPSE levels remained an independent predictor of MACE (HR = 1.693, 95% CI: 1.323–2.165, P < 0.001). ROC analysis showed that a combined HPSE and GRACE model predicted MACE with an AUC of 0.849 (95% CI: 0.787-0.911, P < 0.001). Kaplan–Meier analysis revealed significantly lower MACE-free survival in the high HPSE group (log-rank P < 0.001).

Coronary HPSE is an independent predictor of 6-month MACE in STEMI patients. It also enhances the predictive capability of the GRACE score. Because of this, HPSE serves as a promising biomarker that can help doctors assess risk more accurately and guide clinical decisions.