Predictive value of lipoprotein-associated phospholipase A2 and the ratio of nitric oxide to endothelin-1 for coronary no-reflow in patients with acute coronary syndrome after percutaneous coronary intervention
Objective To investigate the predictive value of lipoprotein-associated phospholipase A2(Lp-PLA2)and the ratio of nitric oxide to endothelin-1(NO/ET-1)for coronary no-reflow(CNR)in patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods A total of 289 ACS patients who underwent emergency PCI at the Fourth People's Hospital of Langfang City from January 2019 to October 2022 were selected.According to the thrombolysis in myocardial infarction(TIMI)flow grades after PCI,the patients were divided into the no-reflow group(TIMI≤2,50 cases)and the normal flow group(TIMI 3,239 cases).Clinical data were collected.Multivariate Logistic regression was used to analyze the factors influencing CNR in ACS patients after PCI.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of Lp-PLA2 and NO/ET-1 for CNR.Results There were statistically significant differences in age,history of diabetes,history of smoking,diastolic blood pressure(DBP),heart function grade of Killip 2-3 grade,preoperative TIMI grade,peak creatine kinase isoenzyme,peak cardiac troponin I(cTnI),N-terminal pro-brain natriuretic peptide(NT-proBNP),D-Dimer,blood glucose,Lp-PLA2,NO,ET-1,NO/ET-1,and time from onset to reperfusion between the two groups(χ2/t=4.168,9.790,7.062,3.337,16.780,6.571,5.904,8.123,9.230,6.409,5.364,9.728,4.135,5.609,6.220,6.504;P＜0.05).Age,smoking history,blood glucose,time from onset to reperfusion,and Lp-PLA2 were risk factors for CNR in ACS patients after PCI(P＜0.05),while NO/ET-1 was a protective factor(P＜0.05).The areas under the ROC curve(AUC)for predicting CNR after PCI using Lp-PLA2 and NO/ET-1 were 0.803 and 0.782,respectively.The combined predictive AUC was 0.896,which was significantly higher than the individual AUCs(Z=4.193,4.815;P＜0.05).Conclusion Lp-PLA2 and NO/ET-1 have predictive value for CNR after PCI in ACS patients,and their combined predictive value is better.
Acute coronary syndromePercutaneous coronary interventionCoronary no-reflowLipoprotein-associated phospholipase A2Nitric oxide to endothelin-1 ratio
万方数据
维普
