Objective To investigate the correlation between serum levels of syndecan-1(SDC-1)and throm-bospondin-1(THBS-1)and the no-reflow after percutaneous coronary intervention(PCI)in patients with acute ST segment elevation myocardial infarction(STEMI).Methods A total of 394 patients with acute STEMI diagnosed and treated in the Cardiovascular Department of the First People's Hospital of Kunshan City,Jiangsu Province from January 2020 to December 2023 were selected as the study group.They were grouped into a reflow subgroup(n=308)and a no-reflow subgroup(n=86)based on whether blood flow was restored after PCI.Additionally,402 healthy individuals who underwent physical exam-ination were included as the control group.Enzyme linked immunosorbent assay(ELISA)was applied to measure the expres-sion levels of serum SDC-1 and THBS-1 in different groups.Pearson/Spearman methods were applied to analyze the correla-tion between serum SDC-1 and THBS-1 expression and clinical data of patients with no-reflow.Logistic regression was ap-plied to analyze the influencing factors of no-reflow occurrence after PCI surgery.Receiver operating characteristic(ROC)curves were plotted to analyze the potential value of serum SDC-1 and THBS-1 expression in predicting no-reflow occur-rence after PCI in acute STEMI patients.Results Compared with the control group,the research group showed high ex-pression of serum SDC-1 and THBS-1(t/P=170.052/＜0.001,62.118/＜0.001).There were obvious differences in the length and number of coronary artery lesions between the no-reflow group and the reflow group(t/x2/P=9.035/＜0.001,11.443/0.001).Compared with the reflow subgroup,the expression of serum SDC-1 and THBS-1 increased in the no-reflow sub-group(t/P=8.885/0.000,8.754/0.000).The expression of serum SDC-1(r/rs/P=0.412/＜0.001,0.539/＜0.001)and THBS-1 in acute STEMI patients with no-reflow after PCI was positively correlated with the length of coronary artery lesions and multi vessel coronary artery lesions(r/rs/P=0.457/＜0.001,0.582/＜0.001).The length of coronary artery lesions,multi vessel coro-nary artery lesions,serum SDC-1,and THBS-1 in patients with acute STEMI were all risk factors for no-reflow after PCI[OR(95％CI)=3.363(1.450-7.794),3.625(1.783-7.370),4.391(2.722-7.084),5.146(3.695-7.167)].The area under the curve(AUC)for predicting no-reflow after PCI in acute STEMI patients based on the expression levels of serum SDC-1,THBS-1 and combined was 0.812,0.770 and 0.882,respectively.The combined prediction efficiency of the two was better than that of each(Z/P=2.046/0.041,3.274/0.001).Conclusion The expressions of serum SDC-1 and THBS-1 are elevated in acute STEMI patients with no-reflow after PCI,they are risk factors for the no-reflow.The combination of the two has a high pre-dictive value for the occurrence of no-reflow.
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