| Objectives:The aim of this study is to explore the predictive value of sST2 combined with BNP for adverse cardiovascular events in patients with acute myocardial infarction after percutaneous coronary intervention by analyzing the changes of soluble growth stimulation expression gene 2 protein,B-type natriuretic peptide and their combination in acute myocardial infarction after PCI and Killip classification.To provide theoretical basis for the early diagnosis and treatment of AMI patients.Methods:1.A total of 204 patients with AMI diagnosed in the Department of Cardiology of Shanxi Bethune Hospital from January 2020 to December 2021 were retrospectively collected as the research objects.All patients underwent PCI within 24 hours of admission.The general information and fasting blood samples of all patients on the next day of admission were collected:age,gender,smoking history,drinking history,underlying diseases,fasting blood glucose,thyroid stimulating hormone,alanine aminotransferase,asparagine aminotransferase,urea,homocysteine,low-density lipoprotein cholesterol,sST2,BNP.2.All patients were followed up for 7-24 months,with an average of 12.73 months.According to the occurrence of cardiovascular adverse events after follow-up,the patients were divided into MACE group and non-MACE group,and the differences between the two groups were compared.3.Binary Logistic regression was used to analyze the independent risk factors affecting the prognosis of AMI patients after PCI.4.The sST2,BNP and combined variables were used as test variables,and the prognosis of AMI patients after PCI was used as the state variable.The receiver operating characteristic curve(ROC)of the subjects was drawn.The predictive value of sST2,BNP and their combined variables for the prognosis of AMI patients undergoing PCI was analyzed.5.According to Killip classification,the patients were divided into KillipⅠ group,KillipⅡ group and Killip Ⅲ-Ⅳ group.The differences and correlation between serum sST2,BNP and Killip classification were analyzed.Results:1.General information:In strict accordance with the study inclusion and exclusion criteria,204 patients were collected.77%(157 cases)were included in the non-MACE group:the average age was 61.48± 11.62 years,79.6%(125 cases)were male,20.4%(32 cases)were female,58.0%(91 cases)were smokers,29.3%(46 cases)were alcohol drinkers,58.6%(92 cases)were hypertension.The MACE group was 23%(47 cases):the average age was 65.72±13.06 years,59.6%(28 cases)were male,40.4%(19 cases)were female,38.3%(18 cases)were smokers,19.1%(9 cases)were alcohol drinkers,and 55.3%(26 cases)were hypertension.2.There were no significant differences in age,drinking history,hypertension,number of stent implantation,fasting blood glucose,TSH,ALT,AST,urea,homocysteine and LDL-C between MACE group and non-MACE group(P>0.05).There were significant differences in gender,smoking history,sST2 and BNP between the two groups(P<0.05).3.The MACE group accounted for 23%(47 cases)of the total population,including 23.4%(11 cases)in the heart failure group,27.7%(13 cases)in the recurrent angina group,14.9%(7 cases)in the recurrent myocardial infarction group,19.1%(9 cases)in the malignant arrhythmia group,and 14.9%(7 cases)in the all-cause death group.4.Binary Logistic regression analysis showed that both sST2 and BNP were independent risk factors for MACE after adjusting the influence of gender and smoking history,with OR values of 1.002 and 1.021,respectively.5.The diagnostic value of sST2,BNP and combined variables for the prognosis of AMI patients after PCI:ROC curve showed that the area under the curve of sST2 was 0.867(P<0.05),the area under the curve of BNP was 0.913(P<0.05),and the area under the curve of sST2 combined with BNP was 0.922(P<0.05).The sensitivity of sST2,BNP and combined variables were 0.879,0.836 and 0.994,respectively,and the specificity were 0.790,0.764 and 0.834,respectively.The results suggested that sST2 and BNP had predictive value for the prognosis of AMI patients after PCI,and the combined variable of sST2 and BNP had higher predictive value,and the difference was statistically significant(P<0.05).6.Comparison of sST2 and BNP in Killip classification:sST2 and BNP levels were positively correlated with Killip classification,among which sST2 was statistically different among Killip groups(P<0.05).BNP levels were significantly different between KillipⅠ group and KillipⅡ group,KillipⅠ group and Killip Ⅲ-Killip Ⅳ group(P<0.05).Conclusions:1.The higher the serum levels of BNP and sST2 in patients with acute myocardial infarction after PCI,the higher the possibility of MACE events within 1 year after PCI.sST2 and BNP can be used as independent risk factors for MACE events in AMI patients after PCI.2.The diagnostic value of combined detection of serum sST2 and BNP for MACE events in AMI patients after percutaneous coronary intervention is higher than that of sST2 and BNP alone. |
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