Circulating Gasdermin D and Interleukin-18 are elevated in acute myocardial infarction: a case-control study from Kirkuk, Iraq

Abstract

Objective: To determine whether circulating Gasdermin D (GSDMD) and interleukin-18 (IL-18) are elevated in acute myocardial infarction (AMI) and evaluate their diagnostic performance.

Methods: In this single-centre prospective case-control study, 110 adults presenting with chest pain at Azady Teaching Hospital, Kirkuk, Iraq (October 2021–August 2023) were enrolled, including 60 WHO-defined AMI cases and 50 matched disease controls. Admission blood samples were stored at −80°C. Serum GSDMD (MyBioSource MBS9137043) and IL-18 (Finetest EH0011) were measured using ELISA. Standard biochemistry, troponin I, C-reactive protein (CRP), and echocardiography were performed. Groups were compared using t-tests or Mann–Whitney tests. Diagnostic performance was assessed using receiver operating characteristic (ROC) curves (p<0.05).

Results: AMI patients had significantly higher GSDMD (2.33 ± 0.53 vs 1.51 ± 0.52 ng/mL) and IL-18 (152.22 ± 54.68 vs 87.18 ± 41.91 pg/mL) than controls (both p<0.001). LDL-cholesterol, total cholesterol, CRP, and white blood cell count were higher, while left ventricular ejection fraction was lower in AMI (all p≤0.021). GSDMD demonstrated strong diagnostic performance (AUC 0.925; 95% CI 0.876–0.967; cutoff 1.804 ng/mL; sensitivity 96.1%; specificity 78.1%). IL-18 showed moderate accuracy (AUC 0.817; 95% CI 0.747–0.918; cutoff 133.5 pg/mL; sensitivity 88.9%; specificity 68.0%).

Conclusions: GSDMD and IL-18 are significantly elevated in AMI and show potential diagnostic value, supporting a role for pyroptosis in AMI. Multicentre validation is required before clinical application.