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| 血清IMA、Gal-3与急性ST段抬高型心肌梗死合并HFpEF患者PCI术后心源性猝死的关系研究 |
| Study on the Relationship Between Serum IMA, Gal-3 and Sudden Cardiac Death After PCI in Patients With Acute ST-Segment Elevation Myocardial Infarction Complicated With HFpEF |
| 投稿时间：2024-06-18 修订日期：2024-06-18 |
| DOI： |
| 中文关键词: 急性ST段抬高型心肌梗死 射血分数保留型心力衰竭 缺血修饰白蛋白 半乳糖凝集素-3 经皮冠状动脉介入 心源性猝死 |
| 英文关键词: Acute ST-segment elevation myocardial infarction Heart failure with preserved ejection fraction Ischemia modified albumin Galectin-3 Percutaneous coronary intervention Sudden cardiac death |
| 基金项目:国家自然科学基金（81673787） |
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| 中文摘要: |
| 目的：探讨血清缺血修饰白蛋白（IMA）、半乳糖凝集素-3（Gal-3）与急性ST段抬高型心肌梗死（STEMI）合并射血分数保留型心力衰竭（HFpEF）患者经皮冠状动脉介入（PCI）术后心源性猝死的关系。方法：选取2020年1月至2022年11月于西安市第九医院收治行PCI术的急性STEMI合并HFpEF患者205例作为研究对象。所有患者术后随访1年，随访期内45例发生心源性猝死纳入研究组，160例未发生心源性猝死纳入对照组。比较两组患者PCI术前血清 IMA、Gal-3水平。多因素Logistic回归分析患者PCI术后心源性猝死的影响因素，使用受试者工作特征（ROC）曲线分析IMA和Gal-3对患者PCI术后心源性猝死的预测价值。结果：相比于对照组，研究组PCI术前血清IMA、Gal-3水平更高（均P 0.05）。多因素Logistic回归分析显示，术前血清IMA水平升高、Gal-3水平升高、多支血管病变、心功能Killip 分级为IV级是急性STEMI合并HFpEF患者PCI术后发生心源性猝死的独立危险因素（P 0.05）。IMA、Gal-3预测急性STEMI合并HFpEF患者PCI术后发生心源性猝死的曲线下面积分别为0.791、0.796，二者联合预测的AUC为0.885，高于单独预测。结论：血清IMA、Gal-3水平升高是急性STEMI合并HFpEF患者PCI术后发生心源性猝死的危险因素，联合血清IMA、Gal-3对急性STEMI合并HFpEF患者PCI术后发生心源性猝死的预测价值较高。 |
| 英文摘要: |
| Objective:To investigate the relationship between serum ischemia modified albumin (IMA), galectin-3 (Gal-3) and sudden cardiac death after percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI) complicated with heart failure with preserved ejection fraction (HFpEF). Methods:205 patients with acute STEMI complicated with HFpEF who underwent PCI in Xi''an Ninth Hospital from January 2020 to November 2022 were selected as the study subjects. All patients were followed up for 1 year, 45 patients with sudden cardiac death were included in the study group, and 160 patients without sudden cardiac death were included in the control group during the follow-up period. The levels of serum IMA and Gal-3 before PCI were compared between two groups. The influencing factors of sudden cardiac death after PCI were analyzed by multivariate Logistic regression analysis, the predictive value of IMA and Gal-3 for sudden cardiac death after PCI was analyzed by receiver operating characteristic (ROC) curve. Results:Compared with control group, the levels of serum IMA and Gal-3 in study group before PCI were higher (all P<0.05). Multivariate logistic regression analysis showed that, elevated preoperative serum IMA level, elevated Gal-3 level, multi-vessel?disease, and cardiac function Killip grade IV were independent risk factors for sudden cardiac death in patients with acute STEMI complicated with HFpEF after PCI (P<0.05). The area under the curve of IMA and Gal-3 in predicting sudden cardiac death in patients with acute STEMI complicated with HFpEF after PCI was 0.791 and 0.796, respectively, the AUC of combined prediction was 0.885, which was higher than that of single prediction. Conclusion:Elevated serum IMA and Gal-3 levels are risk factors for sudden cardiac death in patients with acute STEMI complicated with HFpEF after PCI, and the combination of serum IMA and Gal-3 has a high predictive value for sudden cardiac death in patients with acute STEMI complicated with HFpEF after PCI |
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