High-risk factors for short-term poor prognosis in patients with acute myocardial infarction after percutaneous coronary intervention and the predictive values of Hcy,CysC,Ang Ⅱ,ALD,and BNP in them
Objective To investigate the high-risk factors for short-term poor prognosis of patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI)and the predictive values of serum homocysteine(Hcy),cystatin(CysC),angiotensin Ⅱ(Ang Ⅱ),aldosterone(ALD)and brain natriuretic peptide(BNP)in them.Methods The clinical data of 214 AMI patients admitted to our hospital from June 2020 to January 2023 were retrospectively analyzed.They were followed up for 6 months after discharge.According to the follow-up data,patients were assigned into the good prognosis group(n=170)and the poor prognosis group(n=44).The clinical data of the two groups were compared,and univariate and multivariate analysis were used to analyze the risk factors for the short-term poor prognosis in AMI patients after PCI.Serum Hey,CysC,Ang Ⅱ,ALD and BNP were detected by enzyme cycling,latex immunoturbidimetry,chemiluminescence and direct chemiluminescence,respectively.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of Hey,CysC,AngⅡ,ALD,and BNP alone and their combination detection in the short-term poor prognosis of AMI patients after PCI.Results There were 44(20.56％)AMI patients with poor prognosis after PCI.Multivariate Logistic regression analysis showed that cardiac function≥grade Ⅱ,preoperative cardiac arrest,3 diseased blood vessels,and high levels of plasma bilirubin were the risk factors for poor prognosis after PCI in AMI patients(OR=2.113,2.008,2.273 and 2.143,respectively;P＜0.05).Serum Hcy,CysC,AngⅡ,ALD and BNP in the poor prognosis group were significantly higher than those of the good prognosis group(P＜0.05).The area under the curve(AUC)of Hcy,CysC,Ang Ⅱ,ALD,and BNP and their combination detection for predicting poor prognosis in AMI patients after PCI was 0.777,0.765,0.656,0.721,0.756,and 0.943,respectively.The AUC of the combination detection was significantly higher than that of the single detection,and that of Hcy was significantly higher than Ang Ⅱ.The sensitivity and specificity of the combination detection were 93.20％and 80.00％,respectively.Conclusion AMI patients have a high incidence of short-term poor prognosis after PCI.The combination detection of Hcy,CysC,Ang Ⅱ,ALD,and BNP in AMI patients is helpful to predict the poor prognosis in AMI patients after PCI.The occurrence of poor prognosis in them after PCI is closely related to cardiac function classification,preoperative cardiac arrest,3 diseased blood vessels,and level of plasma bilirubin.
myocardial infarctioncutaneous coronary interventionhomocysteinecystatinangiotensin Ⅱaldosteronebrain natriuretic peptidehigh-risk factorsdiagnostic value
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