Prognostic value of serum gasdermin D in predicting major adverse cardiovascular events in patients with unstable angina: a prospective observational study.

OBJECTIVE: This study investigated the prognostic significance of serum gasdermin D (GSDMD) in unstable angina (UA) and its association with inflammatory cytokines, myocardial injury markers, and 1-year major adverse cardiovascular events (MACE). METHODS: A total of 221 UA patients were prospectively enrolled and followed for 12 months. Serum levels of GSDMD, IL-6, IL-1β, TNF-α, and CRP were measured by ELISA. NT-proBNP, CK-MB, and cTnI were quantified using automated immunoassays. Patients were stratified by 1-year MACE outcomes. RESULTS: Serum GSDMD, IL-6, and IL-1β were significantly higher in the MACE group (all p < 0.01), while TNF-α and CRP showed no differences. GSDMD levels correlated with IL-6 and NT-proBNP (p < 0.001). ROC analysis showed GSDMD predicted MACE with an AUC of 0.800 (95% CI: 0.741–0.859, p < 0.001). Logistic regression identified serum GSDMD levels (OR = 2.601, 95% CI: 1.652–3.701, p < 0.001) and NT-proBNP (OR = 1.055, 95% CI: 1.030–1.080, p < 0.001) as independent predictors of MACE. CONCLUSION: Elevated GSDMD was associated with adverse outcomes in UA and served as an independent prognostic biomarker, suggesting a potential role of pyroptosis-related inflammation in acute coronary syndromes.