Objective To evaluate the level of chromogranin A(CGA)in plasma for the diagnosis of acute ST-segment elevation myocardial infarction(STEMI)patients and its effectiveness in predicting major adverse cardiovascular events(MACE).Methods Subsequently,120 STEMI patients(the observation group)and 50 unstable angina patients(the control group)were selected to compare the levels of plasma CGA and troponin T(CTN-T)between the two groups,and receiver operating characteristic(ROC)curve analysis was performed to determine the specificity and sensitivity of CGA in diagnosing ASTEMI.At the same time,based on the occurrence of MACE within six months of discharge,patients were divided into the MACE group(36 cases)and the non MACE group(84 cases).Clinical related indicators were compared between the two groups,and univariate analysis was used to predict the occurrence of MACE in the observation group patients within six months of discharge.Multivariate logistic regression analysis was used to draw ROC curves to evaluate the predictive value of plasma CGA alone or in combination for MACE occurrence in ASTEMI patients within six months of discharge.Results Compared with the control group,the observation group showed a significant increase in CGA levels within 4 hours of chest pain,and the difference was statistically significant.The area under the curve(AUC)was 0.90,the optimal threshold was 125.75 ng/mL,the sensitivity was 91.67％,and the specificity was 84.00％.However,there was no significant difference in CTN-T within 4 hours.As the degree of coronary stenosis in the observation group increased,plasma CGA levels also gradually increased.Compared with the non MACE group,there were statistically significant differences(P＜0.05)in the rate of troponin depletion,total cholesterol levels,length of hospital stay,Gensini score,and CGA levels before discharge in the MACE group.Multivariate logistic regression showed that the AUC of CGA level before discharge was 0.90,the optimal threshold was 128.60 ng/mL,the sensitivity was 94.44％,and the specificity was 85.71％.The AUC of Gensini score was 0.98,the optimal threshold was 38,the sensitivity was 94.44％,and the specificity was 90.48％.The AUC of CGA combined with Gensini score before discharge was 0.98,the sensitivity was 94.44％,and the specificity was 95.24％.Conclusion CGA levels have good diagnostic specificity and sensitivity in STEMI patients with chest pain＜4 h.Before discharge,CGA and Gensini scores can independently predict the risk of MACE in STEMI patients,and the combination of the two can achieve higher predictive power.
万方数据
维普
