Trajectories of Circulating Monocyte Subsets After ST-Elevation Myocardial Infarction During Hospitalization: Latent Class Growth Modeling for High-Risk Patient Identification

J Cardiovasc Transl Res. 2018 Feb;11(1):22-32. doi: 10.1007/s12265-017-9782-9. Epub 2018 Jan 8.


It remains unclear if the developmental trajectories of a specific inflammatory biomarker during the acute phase of ST-elevation myocardial infarction (STEMI) provide outcome prediction. By applying latent class growth modeling (LCGM), we identified three distinctive trajectories of CD14++CD16+ monocytes using serial flow cytometry assays from day 1 to day 7 of symptom onset in 96 de novo STEMI patients underwent primary percutaneous coronary intervention. Membership in the high-hump-shaped trajectory (16.8%) independently predicted adverse cardiovascular outcomes during a median follow-up of 2.5 years. Moreover, inclusion of CD14++CD16+ monocyte trajectories significantly improved area under the curve (AUC) when added to left ventricular ejection fraction-based prediction model (ΔAUC = 0.093, P = 0.013). Therefore, CD14++CD16+ monocyte trajectories during STEMI hospitalization are a novel risk factor for post-STEMI adverse outcomes. These results provide the first proof-of-principle evidence in support of the risk stratification role of LCGM-based longitudinal modeling of specific inflammatory markers during acute STEMI.

Keywords: Biomarker; Cardiovascular outcomes; Inflammation; Latent class growth modeling; Monocyte subsets; ST-elevation myocardial infarction.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomarkers / blood
  • Case-Control Studies
  • Female
  • GPI-Linked Proteins / blood
  • GPI-Linked Proteins / immunology
  • Hospitalization*
  • Humans
  • Inflammation Mediators / blood
  • Inflammation Mediators / immunology*
  • Lipopolysaccharide Receptors / blood
  • Lipopolysaccharide Receptors / immunology
  • Male
  • Middle Aged
  • Monocytes / immunology*
  • Monocytes / metabolism
  • Percutaneous Coronary Intervention
  • Receptors, IgG / blood
  • Receptors, IgG / immunology
  • Risk Factors
  • ST Elevation Myocardial Infarction / blood
  • ST Elevation Myocardial Infarction / diagnosis
  • ST Elevation Myocardial Infarction / immunology*
  • ST Elevation Myocardial Infarction / surgery
  • Time Factors
  • Treatment Outcome


  • Biomarkers
  • FCGR3B protein, human
  • GPI-Linked Proteins
  • Inflammation Mediators
  • Lipopolysaccharide Receptors
  • Receptors, IgG