| Objective: Acute coronary syndrome(ACS)is a group of clinical syndromes based on the rupture or invasion of coronary atherosclerotic plaque,followed by complete or incomplete occlusive thrombosis.It is a common severe cardiovascular disease.The disease is a serious type of coronary heart disease,including acute myocardial infarction(STEMI,NSTEMI)and unstable angina(UA).ACS can lead to arrhythmia,heart failure,and even sudden death,seriously affecting the quality of life and longevity of patients.With the improvement of scientific research level and clinical work level,its long-term prognosis and survival rate have received more and more attention.It is well known that myocardial fibrosis and ventricular remodeling as follow-up changes in acute myocardial infarction,including left ventricular volume increase,shape change,and infarcted myocardial thinning and non-infarct myocardial thickening,participate in the development of acute myocardial infarction patients with heart failure and other A series of pathophysiological processes of adverse cardiovascular events.Therefore,a variety of biomarkers reflecting myocardial fibrosis have been discovered and urgently needed for clinical use,in which soluble matrix lysin-2(sST2),growth differentiation factor-15(GDF-15)and galectin-3(GAL-3)is the most important.In recent years,there have been many studies on sST2,GDF-15 and GAL-3.Many studies have shown that these three new biomarkers are closely related to myocardial fibrosis and ventricular remodeling after acute myocardial infarction,and can predict adverse cardiovascular disease.The occurrence and development of the event,but the correlation between the three expressions is not clear,and its correlation with myocardial necrosis has not been clearly stated.In this study,patients with unstable angina pectoris were compared to observe the expression of sST2,GDF-15 and GAL-3 in plasma of patients with acute myocardial infarction,to Explore its relevance to ACS types and evaluate its clinical value.Methods: 153 patients with acute coronary syndrome admitted to Shanghai Ninth People’s Hospital of Cardiology from January 2018 to December 2018 were enrolled and divided into two groups,including 78 patients with acute myocardial infarction and 75 patients with unstable angina pectoris..The levels of plasma sST2,GDF-15,and GAL-3 were measured,and the patient’s age,blood pressure,blood glucose,smoking history and past medical history were recorded,and Blood lipids,glycosylated hemoglobin,creatinine,B-type natriuretic peptide(BNP),C-reflective protein(CRP),creatinine protein I(TNI),creatine kinase(CK)and other biochemical indicators were measured.The correlation between sST2,GDF-15,GAL-3 and clinical baseline indicators and the three were analyzed by statistical methods.Results: All the subjects were divided into acute myocardial infarction group and unstable angina group.There was no significant difference in age,gender,diabetes history and smoking history between the two groups(P>0.05),but the difference in hypertension history was statistically significant(P>0.05).There were no statistically significant differences in creatinine,BNP,highdensity lipoprotein,and glycosylated hemoglobin between patients with acute myocardial infarction and those with unstable angina(P>0.05).There was a statistically significant difference in lowdensity lipoprotein levels between the two groups.(P<0.05).Compared with patients with unstable angina pectoris,patients with acute myocardial infarction had higher plasma sST2 levels(P=0.002)and peak CK after myocardial infarction(r=0.425,P<0.001)and TNI peak(r=0.478,P<0.001)was positively correlated.There were no significant differences in GDF-15 and GAL-3 levels between the two groups(P>0.05),and the latter two were not correlated with CK peak and TNI peak levels after myocardial infarction.Plasma sST2 was weakly correlated with GDF-15 level(r=0.348,P<0.001),sST2 and GAL-3 levels.Not relevant(r=0.146,P=0.082),GDF-15 was significantly associated with GAL-3 levels(r=0.518,P<0.001).Conclusion: The level of sST2 in patients with acute myocardial infarction was significantly higher than that in patients with unstable angina pectoris,and was significantly positively correlated with peak CK and TNI after myocardial infarction.There was no significant difference in the levels between GDF-15 and GAL-3 patients.And it was weakly correlated or not correlated with sST2 level,indicating that sST2 may be more closely related to fibrosis caused by myocardial infarction than GDF-15 and GAL-3. |
PDF Full Text Request