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

Background 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. Methods 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. Results 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). Conclusion 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.