Mon4 as a novel monocyte subset with distinct profile and predictor of poor outcomes in individuals with myocardial infarction

Boidin, M ORCID: 0000-0002-1522-1223, Lip, GYH ORCID: 0000-0002-7566-1626 and Shantsila, E (2025) Mon4 as a novel monocyte subset with distinct profile and predictor of poor outcomes in individuals with myocardial infarction. Journal of Thrombosis and Thrombolysis, 58 (6). pp. 699-708. ISSN 0929-5305

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Abstract

Recently, a new monocyte subset known as Mon4, characterized by distinct gene expressions, has been identified but remains poorly characterized. In this study, our objective was to comprehensively characterise Mon4 in healthy individuals and explore its correlation with major adverse cardiovascular events (MACE) in patients with ST-elevation myocardial infarction (STEMI). Our study enrolled 20 healthy individuals and 245 STEMI patients who underwent primary percutaneous coronary intervention (PCI). We analysed monocyte subsets using flow cytometry and collected bone marrow samples from 11 healthy individuals. Cardiac function assessments were performed in STEMI patients through echocardiography within 3 days post-PCI. Mon4 displayed significant differences compared to Mon1, Mon2, and Mon3 in various parameters among healthy individuals, underscoring its distinct profile. In STEMI patients, above-median Mon4 counts were associated with a increased risk of MACE (hazard ratio [HR] 3.11, 95% confidence interval [CI] 1.55–6.24, p = 0.01) and heart failure (HR 3.25, 95% CI 1.14–9.24, p = 0.03) after adjusting for other predictive factors. This study highlights the unique characteristics of Mon4 and its clinical significance. The distinctive gene signature of Mon4, coupled with its association with MACE and heart failure, suggests its potential utility as a biomarker for risk assessment in MI patients. Further investigations are warranted to explore the therapeutic potential of targeting Mon4 in reducing cardiovascular complications following MACE.

Item Type:	Article
Uncontrolled Keywords:	Monocytes; Humans; Myocardial Infarction; Prognosis; Aged; Middle Aged; Female; Male; Heart Failure; Percutaneous Coronary Intervention; ST Elevation Myocardial Infarction; Cardiac function; Major adverse cardiovascular events; Monocyte subsets; Myocardial infarction; Humans; Male; Female; Middle Aged; Monocytes; Aged; Percutaneous Coronary Intervention; ST Elevation Myocardial Infarction; Prognosis; Myocardial Infarction; Heart Failure; 32 Biomedical and Clinical Sciences; 3201 Cardiovascular Medicine and Haematology; Clinical Research; Heart Disease - Coronary Heart Disease; Cardiovascular; Heart Disease; 2.1 Biological and endogenous factors; Cardiovascular; 1103 Clinical Sciences; Cardiovascular System & Hematology; 3201 Cardiovascular medicine and haematology; 3202 Clinical sciences
Subjects:	R Medicine > RA Public aspects of medicine
Divisions:	Research and Innovation Services
Publisher:	Springer Nature
Date of acceptance:	8 May 2025
Date of first compliant Open Access:	2 September 2025
Date Deposited:	02 Sep 2025 14:20
Last Modified:	02 Sep 2025 14:30
DOI or ID number:	10.1007/s11239-025-03111-4
URI:	https://researchonline.ljmu.ac.uk/id/eprint/27085

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