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. 2025 Apr 17:20:e11.
doi: 10.15420/ecr.2024.58. eCollection 2025.

Oxidative Stress-related Gene Signature: A Prognostic Tool for Predicting Survival in ST-elevation MI

Shuo-Wen Sun  1 , Xing-Jie Wang  1 , Ruo-Chen Yan  1 , Lei Huang  2 , Min Hou  1
Affiliations

Oxidative Stress-related Gene Signature: A Prognostic Tool for Predicting Survival in ST-elevation MI

Shuo-Wen Sun et al. Eur Cardiol. .

Abstract

Background: This study aimed to identify differentially expressed oxidative stress-related genes (DEOSRGs) in ST-elevation MI (STEMI) patients and examine their connection to clinical outcomes.

Methods: We conducted a systematic review of Gene Expression Omnibus datasets, selecting GSE49925, GSE60993 and GSE61144 for analysis. DEOSRGs were identified using GEO2R2, overlapping across the selected datasets. Functional enrichment analysis was performed to understand the biological roles of the DEOSRGs. An optimal model was constructed using Least Absolute Shrinkage and Selection Operator penalised Cox proportional hazards regression. The clinical utility of the signature was assessed through survival analysis, receiver operating characteristic (ROC) curve and decision curve analysis. A prognostic nomogram was developed to predict survival risk, with the signature being externally validated using our own plasma samples.

Results: A prognostic signature was formulated, incorporating three upregulated DEOSRGs (matrix metalloproteinase-9, arginase 1, interleukin 18 receptor accessory protein) and three clinical variables (age, serum creatinine level, Gensini score). This signature successfully stratified patients into low- and high-risk groups. Survival analysis, ROC curve analysis and decision curve analysis demonstrated the signature's robust predictive performance and clinical utility within 2 years post-disease onset. External validation confirmed significant outcome differences between the risk groups.

Conclusion: This study identified DEOSRGs in STEMI patients and developed a prognostic signature integrating gene expression levels and clinical variables. While the signature showed promising predictive performance and clinical utility, the findings should be interpreted considering the limitations of small sample size and control group selection.

Keywords: MI; acute coronary syndrome; bioinformatics; oxidative stress; prognosis; transcriptome.

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Conflict of interest statement

Disclosures: The authors have no conflicts of interest to declare. Data availability: The datasets generated and/or analysed during the current study are available in the GEO repository https://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSE60993; https://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSE61144; https://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSE49925 Authors’ contributions: Conceptualisation: SS, LH, MH; methodology: SS, LH, MH; software: SS, LH, MH; validation: SS, LH, MH; formal analysis: SS, LH, MH; investigation: SS, LH, XW, RY; resources: LH, MH; data curation: SS, LH, MH; writing—original draft preparation: SS, LH, MH; writing—review and editing: SS, LH, MH; visualisation: SS, LH; supervision: LH, MH; project administration: SS, LH, XW, RY, MH; funding acquisition: LH, MH. Ethics: The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of Tianjin Chest Hospital (protocol code 2024LW-034, date of approval 28/10/2024). Consent: All patients have given written informed consent.

Figures

Figure 1:
Figure 1:. Identification of Differentially Expressed Oxidative Stress-related Genes from the GSE61144 and GSE60993 Microarray Datasets
Figure 2:
Figure 2:. Overview of Differentially Expressed Oxidative Stress-related Gene Expression and Correlation in Different Prognostic Groups of STEMI Patients
Figure 3:
Figure 3:. The GSE49925 Validation Set Accurately Predicts the Survival of STEMI Patients within 2 Years after Discharge Using the Oxidative Stress-related Gene-based Prognostic Index
Figure 4:
Figure 4:. Oxidative Stress-related Gene-based Prognostic Index Significantly Correlates with the Survival of STEMI Patients from GSE49925 within 2 Years after Discharge
Figure 5:
Figure 5:. Results of External Validation
See this image and copyright information in PMC

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