急性冠状动脉综合征患者PCI术前血清ICAM-1、ESM-1水平与术后冠状动脉慢血流/无复流的相关性

目的 探讨急性冠状动脉综合征(ACS)患者行经皮冠状动脉介入治疗(PCI)术前血清细胞间黏附分子-1(ICAM-1)、内皮细胞特异性分子-1(ESM-1)水平与PCI术后冠状动脉慢血流/无复流(CSF/CNR)的相关性.方法 选择2018年10月—2021年5月华北石油管理局总医院心内科行PCI术的ACS患者354例为...

Correlation between serum ICAM-1 and ESM-1 levels before PCI and postoperative coronary slow blood flow/no-reflow in patients with acute coronary syndrome

Objective To investigate the preoperative serum intercellular adhesion molecule 1(ICAM-1)and endothelial cell specific molecule 1(ESM-1)levels in patients with acute coronary syndrome(ACS)undergoing percutaneous coronary intervention(PCI)and the slow coronary blood flow after PCI/No reflow(CSF/CNR)correlation.Methods From October 2018 to May 2021,354 patients with ACS who underwent PCI in the Department of Cardiology,North China Petroleum Administration General Hospital were selected as the study group.According to whether the patients had CSF/CNR after PCI,the patients were divided into normal blood flow(NCF).There were 291 cases in the subgroup and 63 cases in the CSF/CNR subgroup.Over the same period,360 cases of healthy people who had a physical examination in the hospital were selected as the healthy control group.Detect and compare the levels of serum ICAM-1 and ESM-1 before PCI in the healthy control group and the study group,NCF subgroup and CSF/CNR subgroup,and study group for different disease types.Correlation,logistic regression analysis influencing the risk factors of CSF/CNR after PCI in ACS patients,receiver operating characteristic curve analysis of pre-PCI serum ICAM-1 and ESM-1 levels in the predictive value of CSF/CNR after PCI in ACS patients.Results Compared with the healthy control group,the serum ICAM-1 and ESM-1 levels in the study group were significantly increased before PCI(t/P=104.562/<0.001,52.608/<0.001).Compared with the NCF subgroup,the serum ICAM-1 and ESM-1 levels in the CSF/CNR subgroup before PCI were significantly increased(t/P=19.878/<0.001,21.652/<0.001).There was no significant difference in serum ICAM-1 and ESM-1 levels before PCI in patients with acute ST-segment elevation myocardial infarction(STEMI),acute non-ST-elevation myocardial infarction(NSTEMI),and unstable angina(UAP)in the study group(P>0.05).There was a positive correlation between serum ICAM-1 and ESM-1 levels in the CSF/CNR subgroup before PCI(r/P=0.484/<0.001).High levels of serum ICAM-1 and ESM-1 before PCI are risk factors for CSF/CNR in ACS patients after PCI[OR(95%CI)=3.104(1.536-6.273),3.267(1.741-6.129)].The area under the curve(AUC)of serum ICAM-1 and ESM-1 levels before PCI to predict the occurrence of CSF/CNR after PCI in ACS patients were 0.744 and 0.775,respectively,and the combination of the two was 0.883,which was better than the detection of each separately(Z/P=3.129/0.002,2.798/0.001).Conclusion Serum ICAM-1 and ESM-1 levels were highly expressed in ACS patients before PCI.Both of them are related to the occurrence of CSF/CNR after PCI in ACS patients.They may be clinically potential biomarkers for predicting the occurrence of CSF/CNR after PCI in ACS patients.