| Background and purpose:Cardiovascular disease is the leading cause of death worldwide.Coronary atherosclerotic heart disease accounts for a high proportion,and acute ST segment elevation myocardial infarction(STEMI)is the most serious manifestation of coronary artery disease.Because of its high morbidity and mortality,it is still the main reason affecting public health.Although early percutaneous coronary intervention(PCI)to open the blood vessels has greatly reduced early clinical mortality,its later development into heart failure(HF)and even sudden cardiac death(SCD)still plagues clinicians.This study investigated the statistical relationship between baseline serum soluble ST2(s ST2)levels and major adverse cardiovascular events(MACE)in patients with acute ST-elevation myocardial infarction within 6 months.MACE was defined as new-onset heart failure or cardiogenic death.The aim is to predict high-risk STEMI patients early in the clinic,and to implement personalized treatment in time to improve the poor prognosis.Methods:Approximately 117 patients who were admitted to the Department of Cardiology of ** Hospital from September 2018 to January 2019 and had a clear diagnosis of STEMI,all of whom met the 2013 American Heart Association(ACC)or American Heart Association(AHA)STEMI diagnosis standard.Enzyme-linked immunosorbent assay was used to determine the patient's plasma s ST2 upon admission.At the same time,electrocardiogram,cardiac color Doppler ultrasound,and routine emergency blood tests were performed,including blood routine,biochemical,troponin,amino-terminal B-type natriuretic peptide precursor(NT-pro BNP),Myocardial enzymes,etc.Follow-up and record the occurrence of MACE within 6 months.According to whether MACE occurred,it was divided into MACE event group and non-MACE event group.The general clinical data of the two groups were analyzed,and COX multivariate regression analysis was performed to analyze the independent risk factors of MACE in STEMI patients.Results:A total of 117 patients with STEMI were included in this study.The average age was 65.32 ± 15.20 years,and 70.1% were male.Within 6 months of follow-up,20 cases of heart failure occurred and 2 died.According to the presence or absence of MACE events,they were divided into non-MACE event groups and MACE event groups.(1)Comparison of general clinical data between the two groups of patients,non-MACE event group and MACE event group in age,gender,previous underlying disease,smoking,LVEDD,number of diseased blood vessels,proportion of anterior wall myocardial infarction,creatinine,total cholesterol,low density lipid There were no statistical differences in protein,glycated hemoglobin,and proportion of patients receiving PCI(all P> 0.05);there were statistical differences between the two groups in Killip classification ?II,LVEF,basal heart rate,NT-pro BNP,peak c Tn T,and s ST2values(P <0.05);(2)Baseline s ST2 was positively correlated with basal heart rate(r =0.253),peak c Tn T(r = 0.335),Killip rating(r = 0.401),and NT-pro BNP(r = 0.467)(all P <0.05),And negative correlation with LVEF(r =-0.201)(P <0.05).There was no correlation with left ventricular end-systole(LVEDD)(P = 0.10).(3)The results of multivariate COX regression analysis indicated that the baseline s ST2 value(HR =1.817,95% confidence interval: 1.414-2.164,P = 0.001)was an independent risk factor for MACE events in STEMI patients,and LVEF(HR = 0.818,95%)The confidence interval: 0.800-0.969,P = 0.003)and the peak c Tn T(HR = 1.328,95% confidence interval: 1.011-1.356,P = 0.001)can also independently predict the occurrence of MACE events in patients.Conclusions:The baseline s ST2 value was positively correlated with the patient's basal heart rate,peak c Tn T,Killip grade,and NT-pro BNP,but negatively correlated with the patient's LVEF.The baseline s ST2 value,c Tn T peak,and LVEF were independent risk factors for poor clinical prognosis in STEMI patients and could be independently predicted Patients with STEMI develop MACE risk within 6 months. |
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