Objective:To investigate the predictive value of serum proprotein convertase subtilisin/kexin 9(PCSK9)level for major adverse cardiovascular events(MACE)in patients with acute myocardial infarction(AMI)after per-cutaneous coronary intervention(PCI).Methods:A total of 585 AMI patients who underwent PCI in our hospital from May 2016 to Aug 2020 were enrolled.General data and preoperative serum PCSK9 level were collected.Accord-ing to presence of MACE within one year after PCI,patients were divided into MACE group(n=152)and no MACE group(n=433).Correlation between blood lipids and serum PCSK9 level,and influencing factors for MACE within one year after PCI in AMI patients were analyzed.And the predictive value of serum PCSK9 level for MACE within one year after PCI in AMI patients was analyzed.Results:After one year follow-up,the incidence rate of MACE was 25.98％(152/585).Compared with no MACE group,there were significant rise in preoperative Gensini score,proportions of age≥60 years,multiple infarcted sites,number of diseased vessels ≥2,hypertension,diabe-tes,hyperlipidemia,LVEF＜50％and postoperative slow-flow/no-reflow,serum PCSK9 level[51.95(46.82,56.58)ng/ml vs.72.24(62.37,73.88)ng/ml]in MACE group,P＜0.01 all.Spearman correlation analysis indicated that in AMI patients,serum PCSK9 level was significant positively correlated with levels of total cholesterol(TC)and low den-sity lipoprotein cholesterol(LDL-C)(r=0.728,0.784,P=0.014,0.008).Multivariate Logistic regression analysis indi-cated that age≥60 years,preoperative Gensini score,multiple infarcted sites,number of diseased vessels≥2,hypertension,diabetes,hyperlipidemia,LVEF＜50％,slow-flow/no-reflow after PCI,serum PCSK9 level were independent risk fac-tors for MACE within one year after PCI in AMI patients(OR=2.757～6.888,P＜0.01 all).ROC curve analysis indica-ted that cut-off value,sensitivity,specificity and AUC(95％CI)of serum PCSK9 level was 59.11 ng/ml,88.72％,77.37％and 0.871(0.841～0.897)respectively for predicting MACE within one year after PCI in AMI patients,sugges-ting serum PCSK9 level possessed good predictive value for it.Conclusion:High serum PCSK9 level can increase the risk of MACE after PCI in AMI patients,which has good predictive value for it.
维普
万方数据