Prognostic value of fractalkine and circadian index in patients after Q-myocardial infarction

Abstract

The aim of the study was to assess the prognostic value of fractalkine (FKN) and postinfarction remodeling parameters for predicting long-term cardiovascular events (CVEs) in patients with Q-wave myocardial infarction (Q-MI) after reperfusion therapy. The study included 78 patients: 42 after primary percutaneous coronary intervention (pPCI) and 36 who did not meet the “therapeutic window” criteria and received standard medical therapy. In all patients, plasma FKN levels were measured within the first 24 hours, and a comprehensive clinical and instrumental assessment was performed. During 19 months of follow-up, FKN >0.38 ng/mL and circadian index (CI) ≤1.08 were found to be associated with an increased risk of long-term CVEs (HR=10.71; 95% CI: 4.59–25.02; p<0.0001 for FKN; HR=0.0001; 95% CI: 0.0000–0.33; p=0.0254 for CI). ROC analysis confirmed the high prognostic value of FKN (AUC=0.869). The inclusion of FKN and CI in prognostic models improves risk stratification and optimizes postinfarction follow-up.