Abstract
OBJECTIVE: The immunoproteasome is linked to endothelial function and may act as a proangiogenic factor. This study explored its predictive value for coronary collateral circulation (CCC) in ST-elevation myocardial infarction (STEMI) patients. METHODS: We enrolled 252 STEMI patients from April 2021 to April 2024. Plasma levels of LMP2, LMP7, and PSMB10 were measured using ELISA. ROC curves assessed predictive ability for good CCC. Univariate and multivariate logistic regression analyses identified predictors, and restricted cubic spline (RCS) analysis evaluated the dose-response relationship. Subgroup analysis was also conducted. RESULTS: Patients with good CCC had significantly higher plasma levels of immunoproteasome components. Among them, LMP7 showed the best predictive value (AUC = 0.732), with an optimal cut-off of 3.824 ng/mL. Multivariate logistic regression confirmed LMP7 ≥3.824 ng/mL as an independent predictor for good CCC [OR = 7.914 (4.127-15.174)]. RCS analysis showed a J-shaped association: the odds of good CCC increased notably when LMP7 exceeded 3.824 ng/mL. Subgroup analyses supported these findings. CONCLUSION: Higher plasma immunoproteasome levels, especially LMP7 ≥3.824 ng/mL, were independently associated with good CCC in STEMI patients, suggesting its potential role as a biomarker of collateral development.