Relationship between serum Ang-2 and IFABP levels and survival within 28 days after admission in patients with acute ST segment elevation myocardial infarction complicated with cardiogenic shock
Objective:To explore the relationship between serum angiopoietin-2(Ang-2)and intestinal fatty acid binding protein(IFABP)levels and survival within 28 days after admission in patients with acute ST segment elevation myocardial infarction(STEMI)complicated with cardiogenic shock(CS).Methods:One hundred and six-ty-two patients with STEMI admitted to Handan Central Hospital from May 2020 to October 2023 were selected,there were 61 patients with concurrent CS at the time of visit(concurrent CS group)and 101 patients with no con-current CS at the time of visit(non-CS group);another 98 healthy volunteers were selected as control group.Ac-cording to the survival conditions 28 days after admission,the concurrent CS group was divided into survival group(34 patients survived with good prognosis)and death group(27 patients died with poor prognosis).Clinical data of all subjects were collected and laboratory indexes and serum levels of Ang-2 and IFABP were detected;the correla-tion between serum Ang-2,IFABP and clinical data and laboratory indexes in patients with STEMI complicated with CS,the influencing factors of survival within 28 days after admission in patients with STEMI complicated with CS,and the value of Ang-2 and IFABP in predicting survival within 28 days after admission in patients with STEMI complicated with CS were analyzed.Results:Compared with control group,fasting plasma glucose(FPG),total cholesterol(TC),triglyceride(TG),low density lipoprotein-cholesterol(LDL-C),creatine kinase isoenzyme(CK-MB),homocysteine(Hcy),cardiac troponin Ⅰ(cTnⅠ),Ang-2 and IFABP levels in non-CS group and concurrent CS group were significantly increased,the levels of high density lipoprotein cholesterol(HDL-C)and left ventricular ejection fraction(LVEF)were significantly decreased(P＜0.05);compared with non-CS group,the proportion of patients with multiple myocardial culprit vessels,the levels of TC,TG,CK-MB,Hcy,cTnⅠ,Ang-2 and IFABP in concurrent CS group were significantly increased,while the levels of HDL-C and LVEF were significantly decreased(P＜0.05).Compared with survival group,the proportion of diabetes history,hyperlipidemia history,patients with multiple myocardial culprit vessels,FPG,TC,TG,LDL-C,CK-MB,Hcy,cTnⅠ,Ang-2 and IFABP levels in death group were significantly increased,while the levels of HDL-C and LVEF were significantly decreased(P＜0.05).Serum Ang-2 was positively correlated with IFABP level in STEMI pa-tients complicated with CS(P＜0.05);serum Ang-2 and IFABP were positively correlated with history of diabetes mellitus,history of hyperlipidemia,number of myocardial criminal vessels,FPG,TC,TG,LDL-C,CK-MB,Hcy and cTnⅠ,and negatively correlated with HDL-C and LVEF(P＜0.05).History of diabetes,history of hy-perlipidemia,number of multiple myocardial offender vessels,FPG,TC,TG,LDL-C,CK-MB,Hcy,cTnⅠ,Ang-2 and IFABP were all independent risk factors for survival within 28 days after admission in STEMI patients complicated with CS,both HDL-C and LVEF were independent protective factors for survival within 28 days after admission in STEMI patients complicated with CS(P＜0.05).Compared with the area under curve(AUC)of ser-um Ang-2 and IFABP alone in predicting survival within 28 days after admission of STEMI patients with CS(0.741,0.759),the AUC of serum Ang-2 and IFABP combined in predicting survival within 28 days after admis-sion was higher(0.836,P＜0.05).Conclusion:The serum levels of Ang-2 and IFABP in patients with STEMI complicated with CS are high,which may lead to death within 28 days after admission of patients,the combined detection of Ang-2 and IFABP has a high predictive value for the survival within 28 days after admission of STEMI complicated with CS.
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