Title : Prognostic value of serum Lp-PLA2, sST2 combined with MRR for recurrent ischemia in STEMI patients treated with PCI
Abstract:
Objective: To investigate the changes of serum lipoprotein-associated phospholipase A2 (Lp-PLA2), Soluble suppression of tumorigenicity 2 (sST2) and microcirculatory resistance reserve index (MRR) in patients with ST segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI) and their predictive value for re-ischemia after treatment.
Methods: A total of 90 STEMI patients who underwent PCI in our hospital from January 2021 to January 2023 were selected as the study subjects, and re-ischemic recurrence was observed after discharge. According to whether re-ischemia occurred, the patients were divided into ischemia group and non-ischemia group. The expression levels of serum Lp-PLA2, sST2 and MRR were detected before operation. General clinical data such as age, gender, hypertension and diabetes were analyzed in the two groups, and the risk factors affecting postoperative re-ischemia were analyzed by multivariate Logistic analysis. The predictive value of Lp-PLA2, sST2 and MRR in postoperative recurrent ischemia was analyzed combined with receiver operating curve (ROC).
Results: Re-ischemia occurred in 28 patients, accounting for 31.11%. There were no significant differences in age, sex, hypertension, diabetes, smoking and drinking history between the two groups (P>0.05). The proportion of KILLIP≥III, the level of serum Lp-PLA2, sST2, Cr and NT-proBNP in ischemia group were higher than those in non-ischemia group, and left ventricular ejection fraction (LVEF) and MRR index were lower than those in non-ischemia group, with statistical significance (P<0.05). Multivariate Logistic regression analysis showed that increased proportion of KILLIP≥III patients and the increased levels of Lp-PLA2, sST2, Cr and NT-proBNP were independent risk factors for postoperative re-ischemia, while the increase of LVEF and MRR index was an independent protective factor for postoperative re-ischemia (P<0.05). ROC curve analysis showed that the combined serum Lp-PLA2, sST2 and MRR indexes predicted the area under the curve of re-ischemia in STEMI patients after PCI was 0.812, which was higher than 0.623,0.745 and 0.768 predicted respectively (P<0.05). Conclusion: The increase of serum Lp-PLA2 and sST2 levels and the decrease of MRR index are risk factors for re-ischemia in STEMI patients after PCI, and their abnormal changes can effectively predict the risk of re-ischemia after PCI.
Keywords: lipoprotein-associated phospholipase A2; Soluble suppression of tumorigenicity 2; microcirculatory resistance reserve index; ST segment elevation myocardial infarction; percutaneous coronary intervention
