The Value Of MCRP In Patients With Acute ST-Segment Elevation Myocardial Infarction And Drug Intervention Research

Objective:To evaluate the value of plasma monomer C-reaction protein(mCRP)as a predictor of acute ST-segment elevation myocardial infarction(STEMI)and the influence of long-term statins for premedication on plasma mCRP levels in patients with STEMI undergoing PCI.The correlation between the prognosis of STEMI patients with the plasma mCRP levels and intervention of d long-term statins is investigated.Methods:208 cases of STEMI patients treated in the department of cardiology of our hospital from November 2016 to November 2018 were selected into the observation group.All the patients were treated with emergency percutaneous coronary intervention(PCI)for less than 12 hours.Clinical data of the patients were collected,including gender,age,smoking history,history of diabetes,history of hypertension,etc.Plasma mCRP,electrocardiogram,blood routine,macrobiochemistry,myocardial enzyme,troponin I,d-dimer and other related examinations were completed within 12 hours after admission.In the observation group,208 patients with STEMI were divided into preoperative long-term statins group(62 cases)and preoperative non-long-term statins group(146 cases)according to whether they took statins for a long time before admission.At the same time,40 patients with acute chest pain and normal coronary angiography results were selected as the control group.Differences in plasma mCRP levels between the observation group and the normal control group were analyzed.The patients in the observation group were followed up for 60 days,during which the plasma mCRP levels of 24 hours,7 days and 60 days after operation were measured,the effects of the application history of statins on plasma mCRP levels were analyzed,and the incidence of major cardiovascular adverse events(MACE)between the groups within 60 days was observed.Results:(1)Plasma mCRP levels of patients in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).(2)The mCRP levels were measured 24 hours,7 days after surgery,preoperative long-term statins group was lower than preoperative non-long-term statins group,and the difference was statistically significant(P<0.05),60 days after surgery,there was no statistically significant difference between the two groups(P>0.05).The mCRP levels in the same group decreased gradually with time,and the difference was statistically significant(P<0.05).(3)Logistic regression analysis showed that the OR value of mCRP was 2.365(95%CI=1.075-1.541,P<0.001).The OR value of MPV was 1.238(95%CI=1.325-1.790,P<0.001).Smoking is considered a risk factor for STEMI with an OR of 1.033(95%CI=1.041 ? 1.309,P<0.001).(4)STEMI patients were followed up for 60 days to collect the incidence of MACE.The total incidence of MACE in the preoperative long-term statins group was lower than that in the preoperative non-long-term statins group,and the difference was statistically significant(P<0.05).During the 60-day follow-up,MACE occurred in 47 patients,and the mCRP levels in the MACE group was significantly higher than that in the non-MACE group,and the difference was statistically significant(P<0.05).Conclusion:Plasma mCRP levels are of positive value for early predictor of STEMI,and can predict poor prognosis after STEMI.Long-term application of statins before PCI can reduce plasma mCRP levels and improve the poor prognosis of STEMI patients.