| Background: Acute Myocardial Infarction(AMI)is a common clinical critical cardiovascular disease with a high incidence in elderly patients and is often associated with Acute Heart Failure(AHF).Studies have pointed out that the incidence of AHF in AMI patients within a week is as high as 32%-48%.Since the onset of AHF in AMI patients is rapid and the specificity of early clinical manifestations is not high,how to make early diagnosis and treatment is very important for the prognosis.Previous studies have shown that brain-derived neurotrophic factor(BDNF)not only promotes the growth of neurons,but also plays a key role in the cardiovascular system.Serum carbohydrate antigen 125(CA-125)levels are associated with cardiac systolic dysfunction in patients with Chronic Heart Failure(CHF).However,the value of BDNF combined with CA-125 serum level in predicting AHF after AMI has rarely been reported.The purpose of this study was to evaluate the predictive value of serum BDNF and CA-125 level in early AHF in AMI patients,and to provide a new basis for clinical diagnosis.Objective: To explore the diagnostic value of carbohydrate antigen-125(CA-125)combined with brain-derived neurotrophic factor(BDNF)in early prediction of acute heart failure(AHF)in elderly patients after acute myocardial infarction(AMI),and to analyze the correlation between the levels of these dectecion markers and the severity of AHF.Methods: 144 elderly patients with acute myocardial infarction admitted to the Department of Cardiology of The Second Affiliated Hospital of Anhui Medical University from September 2017 to March 2020 were enrolled.The patients were divided into two groups according to whether AHF occurred within one week after coronary artery reperfusion therapy,including 42 patients with acute left heart failure(heart failure group)and 102 patients without acute left heart failure(control group).The clinical data were collected at admission.The fasting venous blood was drawn,and the serum was measured by an automatic immunoassay analyzer.Venous blood was collected and placed in procoagulant tubes and anticoagulant tubes,respectively.Serum and plasma were collected after centrifugation.Serum CA-125 was determined by Roche Cobas E801 automatic electrochemiluminescence immunoanalyzer.Serum BDNF was determined by ELISA method.Serum troponin I(cTnI)and plasma atrial brain natriuretic peptide(BNP)were determined by chemiluminescence method.CA-125 and BDNF levels were divided into heart failure group and control group according to whether acute heart failure occurred within 1 week after coronary reperfusion treatment,and the clinical data of the two groups were compared;Multivariate logistic regression equation was used to analyze the independent risk factors of AHF in AMI patients;Spearman linear equation was used to analyze the correlation between the levels of CA-125,BDNF and the cardiac function classification of patients with acute heart failure;Draw receiver operating characteristic curve and analyze the predictive value of CA125 combined with BDNF for acute heart failure in elderly patients with acute myocardial infarction;Results: A total of 42 cases of acute heart failure occurred in 144 patients with AMI.Based on this,the clinical data of the two groups of patients were compared and showed that the patients in the heart failure group had troponin,atrial natriuretic peptide,CA-125,BNDF,and the number of diseased branches.Compared with the control group,there are statistical differences(P<0.05);Multivariate logistic regression analysis showed that elevated levels of BNP(OR=1.015),CA-125(OR=23.228),and BNDF(OR=1.455)were independent risk factors for AHF in AMI patients(P<0.05);Spearman’s linear equation showed that the levels of CA-125 and BDNF were positively correlated with the classification of cardiac function(ρ=0.981,0.808,P<0.05);The ROC curve shows that the area under the curve of CA-125 combined with BNDF in early prediction of AHF in AMI patients is higher than that of CA-125 and BDNF alone,with a diagnostic sensitivity of 78.57% and a specificity of 89.22%;Conclusion: Monitoring serum BNDF and CA-125 levels can effectively predict the risk of AHF in elderly patients with AMI,and the levels are related to the severity of clinical cardiac function. |
