Utility Of A New Model To Non-invasively Evaluate Coronary Perfusion Among Patients With STEMI

Aim To explore model involving Lp-PLA2 to non-invasively evaluate coronary perfusion based on TIMI flow grades among patients with STEMI.Methods91 consecutive patients with STEMI underwent emergency PCI in our hospital were included in our study. They were divided into Good Coronary Perfusion group and Poor Coronary Perfusion group according to their TIMI flow grades, with grade 0 and grade 1 included in Good Coronary Perfusion group and the rest two grades in another group. Logistic stepwise regression was conducted to observe the independent risk factors of coronary perfusion. In addition, a model was built according to regression coefficients, and Receiver Operating Characteristic(ROC)curve was applied to evaluate the diagnostic accuracy of the new model.Results A total of 24 patients were include in Good Perfusion group, and 67 in another.Lp-PLA2 and c Tn I were regarded as independent risk factors of coronary perfusion,with odds ratio were 1.009 and 1.028 respectively(P<0.05). The probability of poor coronary perfusion compared to good was described by the equation of P=e CPI/(1+e CPI), with 0.54±0.22 in good group and 0.80±0.18 in poor group. There was significant difference between two groups(P<0.001). And new model was built with CPI(Coronary Perfusion Index) = 0.009 Lp- PLA2+ 0.027 c Tn I-2.115. The areas under ROC curve were 0.0810(0.715-0.885), with optimal cut-off values of0.339, sensitivity of 86.6% and specificity of 66.7%.Conclusions CPI(Coronary Perfusion Index) based on Lp-PLA2 and c Tn I is an non-invasive methods to evaluate coronary perfusion among patients with STEMI with good diagnostic accuracy and high sensitivity. It could also help evaluate coronary perfusion and prognosis for those STEMI patients with contraindications of coronary angiography or other non-invasive equipments. CPI are more appropriate for those patients who are female and those with BMI higher than 25.4 kg/m2, Fbg higher than 2.7mg/dl, D-Dimer higher than 0.4mg/L, TIMI flow grades of 0 and 1and CPI higher than 0.8, especially those with poor coronary perfusion.