NPPB and atherosclerosis: Both NT-proBNP and the soluble form of IL1RL1 are well-known proteins upregulated in response to increased wall stress during STEMI.15 Moreover, both are independent predictors of heart failure and cardiovascular death.16,17 CHI3L1 is an extracellular matrix protein involved in atherosclerosis and plaque rupture.18 This indicates that CHI3L1 upregulation could contribute to STEMI, whereas NT-proBNP and IL1RL1 reflect STEMI-induced mechanical stress on cardiomyocytes.