Prognostic value of serum levels of human cartilage glycoprotein 39 and miR-499-5p in elderly patients with acute myocardial infarction after percutaneous coronary intervention
Objective To investigate the prognostic value of serum levels of human cartilage glycoprotein 39(HC-gp39)and microRNA(miR)-499-5p in elderly patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods A total of 175 elderly AMI patients who underwent PCI treated in Qingdao Central Hospital from February 2020 to May 2022 were selected as the observation group,and 54 healthy patients who underwent physical examination in the hospital during the same period were selected as the control group.Serum HC-gp39 and miR-499-5p levels and cardiac function parameters[left ventricular ejection fraction(LVEF)and left ventricular end-diastolic diameter(LVEDD)]of the observation group and control group were compared,and serum HC-gp39 and miR-499-5p levels of patients in the observation group with different cardiac function grades were compared.The correlation between serum HC-gp39 and miR-499-5p levels and cardiac function parameters was analyzed.After 1-year follow-up,elderly AMI patients were divided into occurrence group and non-occurrence group according to whether major adverse cardiovascular events(MACE)occurred after surgery.Clinical data of occurrence group and non-occurrence group were compared to analyze the influencing factors of postoperative MACE in elderly AMI patients.The predictive value of serum HC-gp39 and miR-499-5p levels and their combination on postoperative MACE in elderly patients with AMI was analyzed.Results The serum levels of HC-gp39,miR-499-5p and LVEDD in the observation group were higher than those in the control group,and LVEF was lower than that in the control group(all P＜0.05).The serum levels of HC-gp39 and miR-499-5p in patients with cardiac function classification Ⅲ were higher than those in patients with cardiac function classification Ⅰ and Ⅱ(all P＜0.05),and the serum levels of HC-gp39 and miR-499-5p in patients with cardiac function classification Ⅱ were higher than those in patients with cardiac function classification Ⅰ(all P＜0.05).Serum HC-gp39 and miR-499-5p levels were positively correlated with LVEDD(r=0.417,0.532,all P＜0.05),and negatively correlated with LVEF(r=-0.567,-0.485,all P＜0.05).After 1 year of follow-up,4 cases were lost to follow-up,the follow-up rate was 97.71％(171/175),and 42 cases had MACE.Gensini score,proportion of unrevascularated blood circulation,troponin T,multi-branch ratio of lesion index,serum HC-gp39 and miR-499-5p levels in the occurrence group were higher than those in the non-occurrence group,and hemoglobin and lymphocyte counts were lower than those in the non-occurrence group,with statistical significance(all P＜0.05).The results of multifactor stepwise regression analysis showed that troponin T(OR=2.818,95％CI:1.238-6.404),Gensini score(OR=3.554,95％CI:1.562-8.084),serum HC-gp39(OR=3.062,95％CI:1.346-6.965)and serum miR-499-5p(OR=4.003,95％CI:1.760-9.160)were the influential factors for postoperative MACE in elderly patients with AMI(all P＜0.05).The sensitivity of serum HC-gp39,miR-499-5p and their combined prediction of MACE after PCI in elderly AMI patients were 83.33％,90.48％and 90.48％,respectively,and the specificity was 80.62％,75.19％and 93.02％,respectively.The area under the curve(AUC)was 0.825,0.816,0.901(all P＜0.05),and the AUC of the combination of the two was higher(P＜0.05).Conclusions Serum HC-gp39 and miR-499-5p levels can be used to predict the prognosis of elderly AMI patients after PCI,and the combination of the two has higher predictive value.
维普
万方数据
