To Study The Changes Of Blood SSt2 And MMP-9 Levels In Patients With CHD During Perioperative Period Of PCI And Their Correlation With SYNTAX Score

Objective: To explore the changes of plasma sST2 and MMP-9 levels in patients with coronary heart disease(CHD)before and after percutaneous coronary intervention(PCI),and to verify the correlation between preoperative plasma sST2,MMP-9 levels and SYNTAX score.Methods: We included 264 patients with CHD(CHD group,n=264 cases),of whom 117 cases received CAG+PCI(PCI group),and 147 cases received CAG alone(CAG group).Another 44 individuals without significant stenosis on coronary angiography were included into control group(CON group,n=44 cases).These patients referred for coronary angiography or interventional therapy at the First Affiliated Hospital of Anhui Medical University from August 2021 to August 2022.The clinical data and preoperative plasma levels of sST2 and MMP-9 were analyzed and compared among different groups.The differences of plasma levels of sST2 and MMP-9 before and after surgery between CAG group and PCI group were analyzed.There were 158 patients with 0-22 SYNTAX score,55 patients with 23-32 SYNTAX score,51 patients with 33 or more SYNTAX score according to the CAG.The differences of clinical indexes and the levels of plasma sST2 and MMP-9 among the three groups were discussed.The association between sST2,MMP-9 and SYNTAX score was tested.Results:(1)We found that the plasma concentrations of sST2 and MMP-9 were higher in CHD group compared with CON group(1415.31 ±334.31 vs 1293.20±219.70 pg/m L,P=0.002,49.64 ±11.22 vs 44.90 ±9.40 ng/m L,P=0.009).(2)There were statistically significant differences in BNP、NLR、SYNTAX score between CAG group and PCI group(P<0.05),while there were no statistically significant differences in other indicators between the two groups(P>0.05).(3)The plasma levels of sST2 and MMP-9 before CAG were lower than those after CAG(1402.19 ±352.53 vs 1404.14 ±420.59 pg/m L,P=0.932;49.43 ±11.94 vs51.22±15.71ng/m L,P=0.063).The plasma concentrations of sST2 and MMP-9 in patients after PCI were higher than those before therapy(1487.97 ±388.43 vs1431.79 ±310.62 pg/ m L,p=0.017),(53.25 ±16.02 vs 49.90 ±10.30 ng/m L,P=0.001).(4)The plasma levels of sST2 and MMP-9 in the subgroups according to the SYNTAX score were declining from the high-risk group to the low-risk group in order [(1321.95 ±311.17)VS(1459.97 ±241.01)VS(1656.36 ±363.46)pg/m L,(46.74 ±11.24)VS(51.17 ±7.87)VS(56.95 ±10.75)ng/m L,P < 0.05].(5)Spearman correlation analysis revealed the association of sST2(r = 0.422)and MMP-9(r=0.372)with SYNTAX score.(6)The association between preoperative sST2,MMP-9 levels and SYNTAX score was still significant even after adjusting for other effects(B=0.008,95%CI=0.003-0.012)、(B=0.147,95%CI=0.017-0.278).Conclusion: The blood sST2 and MMP-9 levels in patients with CHD after PCI were higher than those before surgery.In addition,blood sST2 and MMP-9 levels of patients with coronary heart disease before operation might be correlated with SYNTAX score.