Relationship between H3K18la and Cardiac Function and Prognosis in Patients with ST-segment Elevation Myocardial Infarction

WANG Fang; JING Zengxiu; KANG Guilan

doi:10.12102/j.issn.1672-1349.2025.09.013

Abstract：Objective: To investigate the relationship between histone H3 lysine 18 lactylation (H3K18la) in peripheral blood mononuclear cells (PBMCs) and cardiac function and prognosis in patients with ST-segment elevation myocardial infarction (STEMI). Methods: A total of 145 patients diagnosed with STEMI for the first time between January 2021 and October 2022 were selected as the STEMI group. According to the H3K18la levels at discharge, the STEMI patients were divided into a high H3K18la group (38 cases) and a low H3K18la group (107 cases). Meanwhile, 10 healthy individuals without percutaneous coronary intervention (PCI), chronic kidney disease, diabetes, or a history of ischemic stroke were selected as the control group. H3K18la levels were compared among the groups. The relationship between H3K18la levels and myocardial injury biomarkers, including plasma brain natriuretic peptide (BNP), creatine kinase isoenzyme (CK-MB), and troponin I (cTnI), as well as echocardiographic parameters such as left ventricular end-diastolic volume (LVEDV), LVEDV index (LVEDVI), left ventricular end-systolic volume (LVESV), LVESV index (LVESVI), stroke volume (SV), left ventricular ejection fraction (LVEF), and wall motion score index (WMSI) was analyzed. The occurrence of major adverse cardiovascular events (MACE) was statistically analyzed. Results: Compared with the control group, the H3K18la level in the STEMI group was significantly increased (P < 0.05). There was no statistically significant difference in general data between the high H3K18la group and the low H3K18la group (P > 0.05). At admission and one month after follow-up, the WMSI of the low H3K18la group was higher than that of the high H3K18la group, while the LVEF was lower, with statistically significant differences (P < 0.05). One month after follow-up, the WMSI and LVEF of the low H3K18la group were lower than those of the high H3K18la group, with statistically significant differences (P < 0.05). The differences in the changes between admission and one month after follow-up were not statistically significant (P > 0.05). Compared with the high H3K18la group, the peak cTnI, peak CK-MB, and BNP levels one month after follow-up in the low H3K18la group were significantly higher, with statistically significant differences (P < 0.05). Spearman correlation analysis showed that H3K18la levels were negatively correlated with peak cTnI, peak CK-MB, and BNP levels one month after follow-up (r values were -0.274, -0.375, -0.174, respectively; P < 0.05). There were no statistically significant differences in cardiac death, heart failure readmission, cardiac ischemic events, and all-cause mortality between the high H3K18la group and the low H3K18la group (P > 0.05). Conclusion: Lower H3K18la levels in PBMCs of STEMI patients are associated with myocardial injury and adverse remodeling parameters.