| Objective: By measuring the serum soluble ST2(sST2)level,the study was designed to investigate the relationship between serum sST2 and the severity of coronary artery disease in patients with acute ST-segment elevated myocardial infarction(STEMI).To evaluate the predictive value of short-term prognosis in patients with STEMI after PCI,and to provide a theoretical basis for the assessment of the lesions and short-term prognosis of STEMI patients.Methods: A total of 137 patients with STEMI who underwent emergency PCI in the Department of Cardiovascular Medicine of the First Hospital of China Medical University from December 2018 to October 2019 were selected in this study.More than general clinical data,basic metabolic panel results,echocardiography results,adverse cardiovascular events of all the patient during the hospitalization were collected.The serum sST2 levels of patients were measured by enzyme-linked immunosorbent assay(ELISA).The severity degree of coronary artery disease was determined by the SYNTAX scoring system.Patients were divided into Low SYNTAX Group(SYNTAX score <23,n= 76),Medium SYNTAX Group(23?SYNTAX score<33,n=39),and High SYNTAX Group(SYNTAX score ? 33,n =22).Moreover,the patients were divided into single-vessel disease group(n=24),double-vessel disease group(n=48),and triple-vessel disease group(n=65)according to the number of main coronary artery branches involved.The relationship between the degree of coronary artery disease and serum sST2 level was analyzed.Major adverse cardiovascular events(MACEs)were life-threatening events that occurred within three months after hospital discharge,including reinfarction,heart failure,sudden cardiac death and so on.Various statistical methods were used to predict the role of serum sST2 in short-term prognosis after PCI for STEMI.Results: 1.In Medium and High SYNTAX Groups,CK-MB,NT-pro-BNP,serum s ST2 are higher than these in Low SYNTAX Group(P <0.05).2.The differences of s ST2 distribution in single-branch disease group comparing with double-branch disease group and triple/multi-branch disease group are statistically significant(P<0.001 after adjustment).While the difference of sST2 distribution in double-branch disease group and triple/multi-branch disease group is statistically insignificant(P>0.05).3.There was asignificant correlation between serum sST2 level and SYNTAX score,showing a moderate positive correlation(r=0.481,P<0.001).The distribution of serum s ST2 in different SYNTAX groups was further compared.The differences of sST2 distribution in Low SYNTAX Group comparing with Medium SYNTAX Group and High SYNTAX Group are statistically significant(P<0.001 after adjustment).While the difference of sST2 distribution in Medium SYNTAX Group and High SYNTAX Group is statistically insignificant(P>0.05).4.After modified by age,gender,smoking history,hypertension,diabetes,and hyperlipidemia,multivariate Logistic regression analysis results show serum sST2 is an independent risk factor for medium and high SYNTAX coronary artery disease(OR:1.010,95%CI(1.006-1.013),P<0.001).5.According to the multiple linear regression results,the correlation between serum sST2 and SYNTAX score is affected by lipid profile and LVESD(P<0.05).6.After multivariate analysis with adjustment of other confounding factors,the results show serum sST2(OR:1.018,95%CI : 1.005-1.032,P < 0.05),CK-MB,NT-pro-BNP,and ventricular aneurysm formation are the independent prediction factors for MACEs in STEMI after PCI treatment in the multivariate logistic regression model analysis.The ROC curves to predict MACEs show that the area under the curve of serum sST2 combined with CK-MB is the largest(P < 0.05).Conclusion: 1.High level of serum sST2 indicates severe coronary artery disease.2.The higher the serum sST2 level,the more likely the STEMI patients were to develop MACEs within 3 months after discharge,and it can be combined with CK-MB to improve its predictive value for MACEs. |
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