{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T16:59:18Z","timestamp":1785257958701,"version":"3.55.0"},"reference-count":53,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,7,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Renalase, a stress\u2010responsive enzyme with cardioprotective effects, exhibits a postreperfusion surge that temporally parallels the maturation of microvascular obstruction (MVO). We investigated whether the periprocedural change in renalase (\u0394\u2010renalase) is independently associated with MVO after primary percutaneous coronary intervention (PPCI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This prospective cohort study enrolled 266 consecutive patients with ST\u2010segment\u2013elevation myocardial infarction within 12 hours of symptom onset undergoing PPCI at the Third Xiangya Hospital (August 2024 to July 2025). Serum renalase was measured before and 24 hours after PPCI. Cardiovascular magnetic resonance performed 2 to 5\u2009days after PPCI was used to define MVO. All enrolled patients were followed for 90\u2009days after hospital discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      The cohort had a mean age of 60.1\u2009years, and 31.6% were women. MVO was identified in 118 patients (44.4%). In univariable analysis, \u0394\u2010renalase showed a significant overall association with MVO (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.002) without evidence of nonlinearity (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.743). After adjustment for a prespecified 9\u2010covariate set, \u0394\u2010renalase was modeled using restricted cubic splines and showed an independent, nonlinear association with MVO (overall\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.002; nonlinear\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.001). MVO odds increased more steeply at \u0394\u2010renalase values &gt;0 \u03bcg\/mL. Adding \u0394\u2010renalase improved discrimination (\u0394 area under the receiver operating characteristic curve=0.045), overall accuracy (Brier score 0.214\u20130.197), and net benefit across 30% to 50% risk thresholds. Higher \u0394\u2010renalase was independently associated with greater infarct extent (% left ventricular mass) and, among patients with cardiovascular magnetic resonance\u2013defined MVO, greater MVO extent (% left ventricular mass), as well as lower 90\u2010day peak oxygen pulse. Sensitivity analyses were consistent, with no significant effect modifications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In patients with ST\u2010segment\u2013elevation myocardial infarction treated with PPCI, periprocedural \u0394\u2010renalase is independently associated with cardiovascular magnetic resonance\u2013defined MVO and improves risk stratification, supporting its potential for early risk prediction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinical.trials.gov\">https:\/\/www.clinical.trials.gov<\/jats:ext-link>\n                      ; Unique Identifier: NCT06669520.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.047079","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T03:18:02Z","timestamp":1783739882000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Periprocedural 24\u2010Hour Change in Renalase Adds Incremental Value for Early Risk Stratification of Cardiovascular Magnetic Resonance\u2013Defined Microvascular Obstruction in Patients With ST\u2010Segment\u2013Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: A Prospective Cohort Study"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0864-4295","authenticated-orcid":false,"given":"Ye","family":"Chen","sequence":"first","affiliation":[{"name":"Third Xiangya Hospital, Central South University","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruixuan","family":"Li","sequence":"additional","affiliation":[{"name":"Xiangya Hospital, Central South University","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ru","family":"Fu","sequence":"additional","affiliation":[{"name":"Third Xiangya Hospital, Central South University","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Third Xiangya Hospital, Central South University","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6871-1736","authenticated-orcid":false,"given":"Zhe","family":"Sheng","sequence":"additional","affiliation":[{"name":"Third Xiangya Hospital, Central South University","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Fu","sequence":"additional","affiliation":[{"name":"Third Xiangya Hospital, Central South University","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Xu","sequence":"additional","affiliation":[{"name":"Third Xiangya Hospital, Central South University","place":["Changsha, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8774-1837","authenticated-orcid":false,"given":"Jia","family":"Liu","sequence":"additional","affiliation":[{"name":"Third Xiangya Hospital, Central South University","place":["Changsha, 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