Human epididymis protein 4: a novel predictor of acute non-ST segment myocardial infarction

Abstract The prognostic value of human epididymis protein 4 (HE4) in patients with acute non-ST-segment elevation myocardial infarction (NSTEMI) remains unclear. From August 2021 to October 2023, patients diagnosed with NSTEMI at Hunan Provincial People's Hospital were prospectively enrolled. The HE4 levels of enrolled patients were measured using the chemiluminescent microparticle immunoassay.The endpoint events of the study included hospitalization for unstable angina, readmission for heart failure, nonfatal myocardial infarction, and cardiovascular death.A total of 240 NSTEMI patients were finally included, among whom 53 experienced endpoint events. The serum HE4 levels in patients who experienced events were significantly higher than those in patients without events [154.50 (96.25-324.45) pmol/L vs. 72.5 (50.60,125.65) pmol/L, P < 0.001]. Multivariate Cox regression analysis shows that HE4 [HR = 1.001 (1.000-1.002), P < 0.004] and The Global Registry of Acute Coronary Events (GRACE) risk score [HR = 1.017 (1.003–1.030), P < 0.014] are independent predictors of endpoint events. The receiver operating characteristic (ROC) curve analysis show that the area under the curve (AUC) of HE4 is the largest, with an AUC value of 0.712. In the Kaplan-Meier curve, the survival rate of patients with HE4 > 100.25 pmol/L is lower than that of patients with HE4 ≤ 100.25 pmol/L (P < 0.001).These findings show that HE4 can independently predict the occurrence of endpoint events in patients with NSTEMI.