Predictive Value Of SST2 In The Main Adverse Cardiovascular Events In Patients With Acute Myocardial Infarction Complicated With Diabetes

Objective: To explore the predictive value of s ST2 in the main cardiovascular adverse events in patients with acute myocardial infarction complicated with diabetes,Investigate the correlation between serum s ST2 level and clinical indicators.Methods: We Included 91 cases who are the first inpatients with acute myocardial infarction including patients with STEMI and NSTEMI that were admitted to the coronary angiography intervention in our hospital from January 1,2018 to July 31,2018.They were divided into two groups according to whether they had diabetes(longer than 1year): 49 patients with AMI non-combined diabetes mellitus called A group and 42 patients with AMI and diabetes mellitus called B group.Comparison of gender,age,history of hypertension,type of acute myocardial infarction,Killip classification ≥ II ratio,fasting blood glucose,LDL,2 hours postprandial blood glucose,glycosylated hemoglobin,NT-pro BNP,platelets,Snytax,HDL,UA,CK-MB,creatinine DD dimer,fibrinogen,BMI,TG and other factors were different between the two groups.The main adverse cardiovascular events,such as in-hospital death,recurrent ischemic events and heart failure were observed.Whether s ST2 and MACE in the two groups were different was compared.The correlation between s ST2 and clinical indicators was explored through pearson correlation analysis,and whether s ST2 could predict the prognosis of patients with acute myocardial infarction complicated with diabetes was determined by ROC curve and Logistic regression analysis.Results: 1.Compared with patients with non-combined diabetes mellitus in the acute myocardial infarction group,there was no significant difference in the proportion of gender,hypertension history,STEMI,and Killip classification ≥ II in patients with acute myocardial infarction with diabetes.The obvious difference was that patients with acute myocardial infarction with diabetes were older.2.No differences were found between HDL,UA,CK-MB,Cr,D-D dimer,Fg,BMI,and TG between the two groups.Compared with group A,fasting blood glucose,LDL,postprandial blood glucose,glycosylated hemoglobin,NT-pro BNP,platelet,and Snytax scores in group B were significantly increased(P < 0.05),the difference was statistically significant.The s ST2 level of patients in group B(967±141 pg/ml)was significantly higher than that in patients with non-combined diabetes mellitus(876±129 pg/ml)(P<0.05).3.A total of 47 of the 91 patients had adverse cardiovascular events in hospital,with a total incidence of 51.6 %.MACE events occurred in 28 patients(66.7%)in group B,which was higher than that in 19 patients(38.8%)in group A,and the difference was statistically significant(P < 0.05).Among them,18(42.9%)patients in group B and 10(20.4%)patients in group A had heart failure events during hospitalization,and the difference was statistically significant(P < 0.05).There was no significant difference in nosocomial death and recurrent ischemic events between the two groups(P>0.05).4.Correlation analysis between serum s ST2 level and fasting blood glucose,TG,HDL,postprandial 2h blood glucose,glycosylated hemoglobin,CK-MB,c Tn I,CR,LVEF,Snytax score,LDL,serum s ST2 level and fasting blood glucose,postprandial 2 Hg,glycosylated hemoglobin,NT-pro BNP,CK-MB showed a significant positive correlation,negatively correlated with LVEF(r=-0.21,P=0.04),and was not significantly associated with TG,HDL,c Tn I,Cr,Snytax score and LDL(P>0.05).5.ROC curve analysis showed that s ST2 had a sensitivity of 61.5% at a cutoff value of935.5 pg/ml and a specificity of 33.3% in all AMI patients.s ST2 had predictive value for MACE events in AMI patients(AUC=0.658,P= 0.01[0.546-0.770]).In the AMI population with diabetes mellitus,the sensitivity of s ST2 at the cutoff value of 955 pg/ml was 71.4%,and the specificity was 35.7%,which had predictive value for in-hospital MACE events in patients with diabetes mellitus(AUC=0.8,P=0.02[0.663].-0.973]).And predictive value is greater in the AMI population with diabetesConclusion: s ST2 is a predictor of major adverse cardiovascular events in hospitals with acute myocardial infarction and is more predictive in patients with diabetes;Serum s ST2 level was correlated with blood glucose and cardiac function.