Correlation Between The Changes Of H-FABP Level And Early Cardiac Function In Patients With STEMI And T2DM After Emergency PCI

This study was to observe the dynamic changes of plasma heart-type fatty acid binding protein?H-FABP?level before and after emergency percutaneous coronary intervention?PCI?in patients with acute ST segment elevation myocardial infarction?STEMI?and type 2 diabetes?the experimental group?or STEMI without type 2 diabetes?the control group?,and to observe the correlation between plasma heart-type fatty acid binding protein and early cardiac function in patients after emergency PCI.Subjects and Methods1.Research subjects:This experiment was a prospective study from December 1,2018 to December 1,2019.The patients with STEMI within 6hours from the onset of illness in Yiyang Central Hospital were enrolled.The subjects were divided into two groups according to whether they had diabetes before admission:The diabete group?the experimental group with 80 patients?and the non-diabete group?the control group with 50 patients?.All the subjects accepted emergency PCI after admission and signed consent for emergency PCI.2.Treatment of AMI:All the subjects accepted regular treatment of anticoagulation,antiplatelet aggregation,lipid regulation,and myocardial remodeling in accordance with the 2015 Chinese guidelines about diagnosis and treatment of acute ST-segment myocardial infarction.The emergency PCI operations were performed by two experienced cardiac interventional physicians in our hospital.3.Related datas:clinical datas were collected immediately after admission,such as blood routine,blood lipids,liver and kidney function,troponin,cardiac enzymes,and blood glucose.In addition,NT-proBNP were tested on the first and the third day after PCI.Echocardiography was performed on the seventh day after PCI.The clinical follow-up period was 3 months after discharge for all patients.Echocardiography,NT-ProBNP and other tests were performed in the first month and the third month after discharge.4.Determination of plasma heart-type fatty acid binding protein:5 ml of venous blood was collected in biochemical tubes immediately after admission,6 hours after PCI,12 hours after PCI,and 24 hours after PCI.They were centrifuged after standing and the supernatant was stored in a-80?freezer.The determination of H-FABP was completed by the determination of latex immunoturbidimetry.5.Statistical processing:Statistical analysis was performed using SPSS25 statistical software.Mean number was expressed as mean±standard deviation.H-FABP changes between the experimental group and the control group were analyzed by two-factor repeated measurement analysis of variance for statistical analysis.Differences within the group at different points in time were analyzed by One-way Anova Test;Pearson correlation analysis was used to analyze the relationship between plasma H-FABP value at 6 hours and NT-proBNP and LVEF at different times after PCI;Spearman rank correlation was used to study whether the difference between the H-FABP at 6h and that at 24h??H-FABP?was correlated with the LVEF and NT-ProBNP at 3months after PCI.Rate comparison was used by Chi square test.P<0.05 was used as the criterion for statistical difference.Results1.Comparison of general information between both groupsThere were no statistical differences in clinical data such as gender,age,body mass index,onset time,smoking history,family history,drinking history,hyperlipidemia,hypertension,previous medication history,serum creatinine,blood lipids,etc.However,there was significant statistical difference in glycated hemoglobin?HbA1c?and random blood glucose?BS?between both groups.2.Comparison of plasma H-FABP levels between the diabete group and the non-diabetic group at different points in timeAll patients were alive during hospitalization and within 3 months after discharge,and the plasma H-FABP concentration could be accurately detected for 4 times.In the both group,plasma H-FABP levels increased sharply in 6hours after PCI,began to decrease significantly at 6 hours,and continued to decline at 12 hours,and 24 hours after PCI?p<0.001?.3.Comparison of plasma H-FABP levels between the diabete group and the non-diabetic group before and after PCIThe plasma H-FABP levels in the diabete group were higher than those in the non-diabetic group at immediately before PCI,and 6 hours,12 hours and24 hours after PCI?p<0.001?.In addition,the plasma H-FABP levels in the diabete group decreased more slowly than the non-diabetic group during 6-24hours after PCI.4.Correlation between plasma H-FABP level and LVEFThe diabete group:The plasma H-FABP levels at 6 hours after PCI were negatively correlated with the LVEF at 1 week,1 month and 3 month after PCI?r=-0.23,p=0.03;r=-0.25,p=0.02;r=-0.28,p=0.01?.The non-diabetic group:The plasma H-FABP levels at 6 hours after PCI were negatively correlated with the LVEF at 1 week,1 month and 3 month after PCI?r=-0.19,p=0.04;r=-0.31,p=0.02;r=-0.34,p=0.01?.5.Correlation between plasma H-FABP level and NT-ProBNPThe diabete group:The plasma H-FABP levels at 6 hours after PCI were positively correlated with the NT-ProBNP at 1 week,1 month and 3 month after PCI.?r=0.31,p=0.005;r=0.24,p=0.03;r=0.22,p=0.04?.The non-diabetic group:The plasma H-FABP levels at 6 hours after PCI were positively correlated with the NT-ProBNP at 1 week,1 month and 3month after PCI?r=0.54,p<0.0001;r=0.29,p=0.03;r=0.20,p=0.01?.6.Correlation between the dynamic changes of plasma H-FABP??H-FABP?and the LVEF and NT-ProBNP at 3 months after PCIThe diabete group:The dynamic change of H-FABP??H-FABP:the difference between the H-FABP at 6h and that at 24h?after PCI was negatively correlated with the left ventricular ejection status at 3 month after PCI?r=-0.243,p=0.03?;The dynamic change of H-FABP??H-FABP?after PCI was negatively correlated with the NT-ProBNP level at 3 month after PCI?r=-0.33,p=0.003?;The non-diabetic group:The dynamic change of H-FABP??H-FABP:the difference between the H-FABP at 6h and that at 24h?after PCI was negatively correlated with the left ventricular ejection status at 3 month after PCI?r=-0.452,p=0.001?;The dynamic change of H-FABP??H-FABP?after PCI was negatively correlated with the NT-ProBNP level at 3 month after PCI?r=-0.451,p=0.001?;Conclusions1.The level of H-FABP in STEMI patients with T₂DM after emergency PCI has a tendency to decline more slowly than that in patients without T₂DM.2.Changes in H-FABP levels have a good predictive value for the early cardiac function of STEMI patients with T₂DM.