Predictive value of fQRS wave and serum Serpina3,25-(OH)D3 for ST-segment resolution after PCI in STEMI patients
Objective To investigate the predictive value of fragmented QRS(fQRS)wave and serine protease inhibitor A3(SERPI-NA3),25-hydroxyvitamin D3[25(OH)D3]for ST-segment resolution after percutaneous coronary intervention(PCI)in ST-eleva-tion myocardial infarction(STEMI)patients,aiming to provide support for clinical treatment.Methods A total of 200 STEMI pa-tients who underwent PCI in Fuyang Cancer Hospital from January 2019 to October 2022 were selected as the study subjects.Based on the ST-segment resolution at 120 minutes after PCI,the patients were allocated to the good resolution group(n=137)and the poor resolution group(n=63).The incidence of fQRS wave and the levels of serum Serpina3 and 25-(OH)D3 were compared between the two groups.The consistency between the incidence of fQRS wave and poor ST-segment resolution after PCI was analyzed by the Kappa consistency test.The receiver operating characteristic(ROC)curve was plotted to explore the pre-dictive value of serum Serpina3 and 25-(OH)D3 for poor ST-segment resolution.The occurrence of major adverse cardiovas-cular events(MACE)was also compared between the two groups during a 6-month follow-up.Results The incidence of fQRS wave before PCI in the poor resolution group was significantly higher than that in the good resolution group(49.21%vs.10.22%;P<0.05).The level of serum Serpina3 in the poor resolution group was significantly higher than that in the good resolution group,while the level of 25-(OH)D3 was significantly lower than that in the good resolution group(P<0.05).The Kappa value of the consistency between the incidence of fQRS wave before PCI and poor ST-segment resolution after PCI was 0.422.The areas under the ROC curve for the prediction of poor ST-segment resolution after PCI by serum Serpina3,25-(OH)D3,and their combination were 0.689,0.867,and 0.887,respectively.After 6 months,the total inci-dence of MACE in the poor resolution group was significantly higher than that in the good resolution group(22.22%vs.8.03%;P<0.05).Conclusion A moderate consistency was observed between fQRS wave on pre-PCI ECG and poor ST-segment resolution after PCI in STEMI patients.The levels of serum Serpina3 and 25-(OH)D3 have a high predictive value for poor ST-segment resolution after PCI.These three factors can be used as early evaluation indicators for poor ST-segment resolution after PCI in STEMI patients.
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