血清骨保护素与急性ST段抬高型心肌梗死患者院内主要不良心血管事件的相关性

目的:探讨急性ST段抬高型心肌梗死(STEMI)患者血清骨保护素(OPG)水平与其院内主要不良心血管事件(MACE)的相关性。方法:340例接受急诊经皮冠状动脉介入治疗的STEMI患者,根据是否发生院内MACE分为MACE组(58例)和非MACE组(282例)。采用ELISA法测定患者入院时的血清OPG水平。结果:MACE组患者的血清OPG水平显著高于非MACE组[(2.4±0.5)ng/mL vs(1.6±0.3)ng/mL,P0.01]。随着OPG水平的升高,MACE发生率也逐渐增加(P0.05)。多因素Logistic回归分析表明,OPG水平是STEMI患者发生院内MACE的独立预测因素(OR 2.18,95%CI 1.36~3.49,P0.01)。ROC曲线分析提示,OPG预测院内MACE发生的最佳截点为1.68 ng/mL,其敏感性为68%,特异性为78%。结论:STEMI患者的血清OPG水平与院内MACE的发生密切相关,且高血清OPG水平是其发生院内MACE的独立危险因素。

Association between serum osteoprotegerin and in hospital major adverse cardiac events in patients with acute ST segment elevation myocardial infarction

Objective: To investigate the relationship between serum osteoprotegerin (OPG) level and in-hospital major adverse cardiac events (MACE) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: A total of 340 patients with STEMI receiving primary percutaneous coronary intervention were included. According to the presence or absence of in-hospital MACE, these patients were divided into the MACE (n=58) and non-MACE (n=282) groups. The serum OPG level at admission was measured by ELISA method. Results: Patients in the MACE group showed a significantly higher level of OPG than in the non-MACE group [(2.4 ± 0.5) ng/mL vs (1.6 ± 0.3) ng/mL, P<0.01]. The occurrence rate of MACE was significantly increased along with the elevated OPG level (P<0.05). Multivariate logistic regression analysis indicated that OPG was an independent predictor of in-hospital MACE in STEMI patients (OR 2.18, 95% CI 1.36~3.49, P<0.01). ROC curve analysis showed that the optimal cut-off value of OPG for predicting in-hospital MACE was 1.68ng/mL, with a sensitivity of 68% and a specificity of 78%. Conclusion: In patients with STEMI, serum level of OPG is closely associated with the occurrence of in-hospital MACE. The elevated OPG level is an independent risk factor of in-hospital MACE in STEMI patients.