血清同型半胱氨酸、胱抑素C、超敏C-反应蛋白水平对急性ST段抬高型心肌梗死患者PCI术后并发心力衰竭的预测价值

目的 探讨血清同型半胱氨酸、胱抑素C、超敏C-反应蛋白水平在预测急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入(PCI)术后心力衰竭(HF)中的应用价值。方法 回顾性选取2020年7-12月行PCI术的STEMI患者168例，术后随访1年，依据STEMI患者术后是否发生HF分为两组，HF组92例，非HF组76例，收集患者临床资料，比较两组各指标的差异，用多因素Logistic回归分析STEMI患者行PCI术后发生HF的危险因素，绘制ROC曲线，分析血清同型半胱氨酸、胱抑素C、超敏C-反应蛋白水平对STEMI患者PCI术后发生HF的预测价值。结果 HF组的年龄、同型半胱氨酸、胱抑素C、超敏C-反应蛋白水平显著高于非HF组，左心室射血分数(LVEF)水平低于非HF组，差异有统计学意义(P<0.05);两组性别、吸烟史、饮酒史、糖尿病史、高血压史、单支血管病变，心率、体质量指数(BMI)、肌钙蛋白T、肌酸激酶同工酶(CK-MB)、甘油三脂、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、尿酸、肌酐差异均无统计学意义(P>0.05)。多因素Logistic回归分析结果显示，年龄...

Predictive values of serum homocysteine,cystatin C and high sensitive C-reactive protein levels on heart failure after percutaneous coronary intervention in patients with acute ST-elevation myocardial infarction

Objective To investigate the value of serum homocysteine, Cystatin C and high-sensitivity C-reactive protein in predicting heart failure (HF) after percutaneous coronary intervention (PCI) in patients with acute ST-elevation myocardial infarction (STEMI). Methods A total of 168 patients with STEMI who underwent PCI from July 2020 to December 2020 were retrospectively selected as the research objects. They were followed up for 1 year. They were assgined to HF group (n=92) and non-HF group (n=76) according to the presence or absence of HF after PCI. The clinical data of the patients were collected and compared between the two groups were compared. Multivariate logistic regression was used to analyze the risk factors, and ROC curve was drawn to analyze the predictive value of serum homocysteine, Cystatin C and high-sensitivity C-reactive protein for HF after PCI in STEMI patients. Results The age, homocysteine, Cystatin C and high sensitive C-reactive protein levels in HF group were significantly higher than those in non-HF group, while the left ventricular ejection fraction (LVEF)level was significantly lower (P<0.05). There were no significant differences in gender, smoking history, drinking history,diabetes history, hypertension history, single vessel disease, heart rate, body mass index (BMI), troponin T, creatine kinase MB (CK-MB), triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, uric acid and creatinine between the two groups (P >0.05). Multivariate logistic regression analysis showed that age, homocysteine, Cystatin C, and high-sensitivity C-reactive protein were independent risk factors for HF after PCI in STEMI patients. ROC curve analysis showed that the area under the curve (AUC) of serum homocysteine, Cystatin C and hypersensitive C-reactive protein in predicting HF after PCI in STEMI patients was 0.706, 0.698 and 0.762 respectively, with the specificity of 0.609, 0.641 and 0.601 respectively, and the sensitivity of 0.724, 0.697 and 0.812 respectively. AUC of the combined prediction of serum homocysteine, Cystatin C and hypersensitive C-reactive protein was 0.817, with the specificity and sensitivity of 0.690 and 0.868, respectively. Conclusion Serum homocysteine, Cystatin C and high sensitive C-reactive protein are the risk factors of HF after PCI in STEMI patients, and their combination detection has a high clinical value in predicting HF after PCI in STEMI patients.