Pre-procedural IL-18, hs-CRP, and VEGF as predictors of adverse outcomes in acute myocardial infarction patients undergoing percutaneous coronary intervention

Background Identifying biomarkers that predict adverse outcomes after percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) could improve risk stratification and guide clinical management. Objectives To evaluate the prognostic value of pre-procedural IL-18, hs-CRP, and VEGF levels in predicting major adverse cardiovascular events (MACEs) in AMI patients undergoing PCI. To assess their utility in risk stratification compared to traditional clinical parameters. Methods This retrospective cohort study analyzed patients with AMI undergoing PCI between January 2023 and December 2024, with healthy controls for comparison. Serum interleukin-18 (IL-18), high-sensitivity C-reactive protein (hs-CRP), and vascular endothelial growth factor (VEGF) levels were measured before and after PCI. Patients were followed-up for 12 months to assess MACEs, including cardiac death, target vessel revascularization, ischemic stroke, and heart failure hospitalization. Patients were stratified into the good prognosis (no MACEs) and poor prognosis (MACEs) groups. Logistic regression and receiver operating characteristic (ROC) curve analyses were used to evaluate the prognostic value of these biomarkers. Results A total of 170 AMI patients and 100 healthy controls were included. All three biomarkers were significantly elevated in AMI patients compared to controls and decreased after PCI (all p 0.01). Pre-procedural IL-18, hs-CRP, and VEGF levels were significantly higher in the poor prognosis group ( n = 40) than in the good prognosis group ( n = 130) (all p 0.01). Traditional clinical characteristics did not differ between outcome groups (all p 0.05). Logistic regression identified all three biomarkers as independent predictors of poor prognosis (IL-18, OR = 26.075; hs-CRP, OR = 2.284; VEGF, OR = 1.643; all p 0.001). ROC analysis demonstrated excellent discriminatory capacity, with area under the curve values of 0.803 for IL-18, 0.838 for hs-CRP, and 0.800 for VEGF (all p 0.001). Conclusion Elevated preprocedural IL-18, hs-CRP, and VEGF levels independently predict adverse outcomes in AMI patients undergoing PCI, offering superior risk stratification compared to traditional clinical parameters.