Prognostic Value Of SYNTAX Score Combined With Lp-PLA₂ Testing In Patients With AMI Undergoing Primary PCI

Objective To investigate the predictive effect of SYNTAX Score combined with Lipoprotein-associated phospholipase A2 testing in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention..Methods A total of 116 patients diagnosed AMI and coronary angiography?CAG?was performed in TEDA International Cardiovascular Hospital between September2014 and March 2015 were followed up to 1 year at least.Admission plasma Lp-PLA₂ and other laboratory biochemical tests was measured in all eligible patients admitted to hospital before CAG.To calculated SYNTAX Score according to the CAG results.The treatment of patients followed the international guidelines.The patients were divided into another 3 groups: Low risk group,Medium risk group and High-risk group,basing on SYNTAX Score and Lipoprotein-associated phospholipase A2 testing systems.We recorded and analyzed the association between incidence of MACE and clinical data.The relationship between SYNTAX score and Lp-PLA₂ level was studied by Pearson correlation analysis,survival analysis was conducted by Kaplan-Meier method,univariate and multivariate analysis were performed by Cox proportional hazard model,and the area under curve?AUC?of ROC analysis was used to compare two methods.Results Our study collected 116 cases of patients meeting the requirement,including 82 cases of male 34 cases of female,with an average age of 59 years old,Hypertension 64 cases,26 patients with diabetes and 16 cases with hyperlipidemia.Single or double branch of coronary artery lesions in 80 cases,three or left main lesion 36 cases.Follow-up was 12.26±3 months.The comparison of the 3 SYNTAX Score group patients showed that age ?history of diabetes?the heart rate on admission?endogenous creatinine clearance?low density lipoprotein cholesterol?b-type natriuretic peptide?GRACE score?complex vascular lesions and left ventricular ejection fraction were statistically different.Pearson correlation analysis showed that there was a positive correlation between SYNTAX score and GRACE score,but there was not correlation between SYNTAX score and Lp-PLA₂ lever?r=-0.135,p=0.15?.Survival analysis presented that by SYNTAX score system,MACE occurrence rates in High-risk group were 66.67%,which were higher than that both in medium risk group?23.81%?and Low risk group?23.99%?,while the scores between Medium and Low risk groups were similar,P>0.05.And by Lp-PLA₂ lever system,the MACE occurrence rates in Low risk group,Medium risk group and high-risk group were elevated accordingly as 8.33%,10.71% and 21.88% respectively.Cox proportional hazard model and ROC analysis indicated that SYNTAX score and Lp-PLA₂ lever had the important predictive value for lone term prognosis of patients with ST segment elevation acute myocardial infarction undergoing primary percutaneous coronary intervention.ROC analysis of SYNTAX score,Lp-PLA₂ lever and the combination of SYNTAX score and Lp-PLA₂ lever showed that 3 of them all had good predictive value for MACE occurrence,three of their AUC had statistic differences.Conclusion This research results showed that SYNTAX score and GRACE had obvious correlatio.The research results showed that there was no obvious correlation between the SYNTAX score and Lp-PLA₂ level.The SYNTAX score and the Lp-PLA₂ lever had the important predictive value for lone term prognosis of patients with ST segment elevation acute myocardial infarction undergoing primary percutaneous coronary intervention.The SYNTAX Score combined with Lp-PLA₂ testing can improve Prognostic value for lone term prognosis of patients with acute myocardial infarction undergoing primary percutaneous coronary intervention.