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Objectives <p>To investigate the levels of human cartilage intermediate layer protein 1 (CILP-1) in elderly patients with acute myocardial infarction (AMI), its correlation with myocardial ischemia and ventricular remodeling, and its prognostic value for major adverse cardiovascular events (MACE).</p> Methods <p>A total of 1869 elderly patients admitted to the Second Affiliated Hospital of Soochow University for chest pain within 24&#xa0;h of onset were enrolled. Participants were categorized into the AMI group (<i>n</i> = 849) and the non-AMI group (<i>n</i> = 1020). The plasma CILP-1 levels were measured upon admission. In the AMI group, the wall motion score (WMS) was recorded within 24&#xa0;h of pain onset, and the SYNTAX score was evaluated based on coronary angiography. Statistical analysis of MACE occurrence during 12-month follow-up was performed in the AMI patients.</p> Results <p>CILP-1 levels were significantly higher in the AMI group compared to the non-AMI group (1058.33 [793.73, 1397.05] ng/L vs. 975.60 [700.24, 1279.41] ng/L, <i>P</i> &lt; 0.05), and notably higher in the MACE group than in the non-MACE group (1650.3 [1074.61, 1718.04] ng/L vs. 976.40 [738.00, 1287.78] ng/L, <i>P</i> &lt; 0.05). CILP-1 expression correlated positively with WMS, SYNTAX score, myocardial injury markers, C-reactive protein (CRP), and left-ventricular end-diastolic diameter (LVDd), and negatively with left-ventricular ejection fraction (LVEF) (<i>P</i> &lt; 0.05). Univariate Cox analysis indicated that CILP-1, age, cardiac troponin T (cTn-T), creatine kinase-MB (CK-MB), myoglobin, CRP, LVEF, WMS, and SYNTAX were significant predictors of MACE in AMI patients (<i>P</i> &lt; 0.05). After adjusting for confounding factors, CK-MB, LVEF, WMS, and SYNTAX remained independent predictors of MACE (<i>P</i> &lt; 0.05). Furthermore, incorporating CILP-1 into a baseline model (comprising LVEF, male sex, SYNTAX, WMS, CRP, and CK-MB) significantly enhanced risk estimation for MACE (AUC 0.78, 95% <i>CI</i>:0.75–0.80 vs. AUC 0.59, 95% <i>CI</i>:0.55–0.62; <i>P</i> &lt; 0.05).</p> Conclusions <p>Elderly AMI patients present significantly elevated CILP-1 levels, which positively correlate with the degree of ischemia and ventricular remodeling. CILP-1 may serve as a potential prognostic biomarker for risk stratification in elderly AMI patients.</p>

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Clinical prognostic value of cartilage intermediate layer protein 1 (CILP-1) in elderly patients with acute myocardial infarction

  • 期刊论文

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  • 发表日期：

    2026年3月10日

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  • Li Xiang,
  • Li Xiong,
  • Yi Li,
  • JiaPeng Chu,
  • Chunlai Shao

摘要

Objectives

To investigate the levels of human cartilage intermediate layer protein 1 (CILP-1) in elderly patients with acute myocardial infarction (AMI), its correlation with myocardial ischemia and ventricular remodeling, and its prognostic value for major adverse cardiovascular events (MACE).

Methods

A total of 1869 elderly patients admitted to the Second Affiliated Hospital of Soochow University for chest pain within 24 h of onset were enrolled. Participants were categorized into the AMI group (n = 849) and the non-AMI group (n = 1020). The plasma CILP-1 levels were measured upon admission. In the AMI group, the wall motion score (WMS) was recorded within 24 h of pain onset, and the SYNTAX score was evaluated based on coronary angiography. Statistical analysis of MACE occurrence during 12-month follow-up was performed in the AMI patients.

Results

CILP-1 levels were significantly higher in the AMI group compared to the non-AMI group (1058.33 [793.73, 1397.05] ng/L vs. 975.60 [700.24, 1279.41] ng/L, P < 0.05), and notably higher in the MACE group than in the non-MACE group (1650.3 [1074.61, 1718.04] ng/L vs. 976.40 [738.00, 1287.78] ng/L, P < 0.05). CILP-1 expression correlated positively with WMS, SYNTAX score, myocardial injury markers, C-reactive protein (CRP), and left-ventricular end-diastolic diameter (LVDd), and negatively with left-ventricular ejection fraction (LVEF) (P < 0.05). Univariate Cox analysis indicated that CILP-1, age, cardiac troponin T (cTn-T), creatine kinase-MB (CK-MB), myoglobin, CRP, LVEF, WMS, and SYNTAX were significant predictors of MACE in AMI patients (P < 0.05). After adjusting for confounding factors, CK-MB, LVEF, WMS, and SYNTAX remained independent predictors of MACE (P < 0.05). Furthermore, incorporating CILP-1 into a baseline model (comprising LVEF, male sex, SYNTAX, WMS, CRP, and CK-MB) significantly enhanced risk estimation for MACE (AUC 0.78, 95% CI:0.75–0.80 vs. AUC 0.59, 95% CI:0.55–0.62; P < 0.05).

Conclusions

Elderly AMI patients present significantly elevated CILP-1 levels, which positively correlate with the degree of ischemia and ventricular remodeling. CILP-1 may serve as a potential prognostic biomarker for risk stratification in elderly AMI patients.