The Effect of Serum FGF23,MMP-14,FIB,and D-D Expression on Left Ventricular Remodeling after Acute Myocardial Infarction
Objective To observe the occurrence of left ventricular remodeling(LVR)in patients with acute myocar-dial infarction(AMI),and analyze the relationship between the expression of matrix metalloproteinase-14(MMP-14),fibroblast growth factor 23(FGF23),fibrinogen(FIB),D-dimer(D-D)and LVR.Methods A total of 59 AMI patients who underwent percutaneous coronary intervention(PCI)treatment and had reflow at the First People's Hospital of Urumqi from March 2018 to November 2019 were non-randomly selected as the study objects.Based on whether LVR occurred after surgery,they were divided into an occurrence group(n=16)and a non occurrence group(n=43).General information was investigated between the two groups,and the serum levels of FGF23,MMP-14,FIB,and D-D were compared between the two groups before PCI.Logistic regression models were used to analyze the impact of preopera-tive serum levels of the above indicators on the postoperative LVR of AMI patients.Receiver operating characteristic(ROC)curve and decision curve were plotted to judge the predictive value.Results Among 59 AMI patients,there were 16 patients had LVR after PCI,with an incidence rate of 27.1%.The average levels of serum FGF23,MMP-14,FIB,and D-D levels before PCI treatment in the occurrence group were higher than those in the non occurrence group,and the differences were statistically significant(all P<0.05).There was no statistically significant difference in other data between the two groups(all P>0.05).Logistic regression analysis showed that overexpression of serum FGF23,MMP-14,FIB,and D-D before PCI was an independent risk factor for LVR in AMI patients after PCI(OR=22.750,1.239,2.998,2.447;95%CI=1.214～426.469,1.013～1.515,1.118～8.034,1.036～5.779;all P<0.05);The ROC curve shows that the area under curve(AUC)for predicting LVR in AMI patients before PCI,both individually and in combination,is greater than 0.70,indicating ideal predictive value,and the combined predictive effect is the best.Ac-cording to the decision curve,within the threshold range of 0.15～1.00,the net benefit rate of the joint prediction model is better than that of FIB,D-D,FGF23,and MMP-14 predicted separately.Conclusion Overexpression of se-rum FGF23,MMP-14,FIB,and D-D in AMI patients before PCI may indicate a high risk of post infarction LVR.It may be considered to test serum FGF23,MMP-14,FIB,and D-D levels in AMI patients before PCI to assess LVR risk and guide intervention.
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