缺血修饰白蛋白与介入治疗非ST段抬高急性冠状动脉综合征预后的关系

Prognostic value of ischemic modified albumin for patients with non-ST-segment elevation acutecoronary syndrome undergoing percutaneous coronary intervention

对214例非ST段抬高急性冠状动脉综合征（NSTEACS）患者均行冠状动脉造影及冠状动脉介入治疗，并测定入院时缺血修饰白蛋白（IMA）水平，随访1年临床主要不良心血管事件（MACE），根据ROC曲线选择IMA阈值来判断1年预后，Kaplan—Meier生存分析及Cox回归分析IMA和NSTEACS预后的关系。结果显示，21例在1年的随访中发生MACE事件，其中6例死亡，8例为非致死性心肌梗死，7例再次血运重建。MACE患者IMA水平显著高于非MACE患者（P〈0．01）；ROC分析显示IMA预测1年MACE的曲线下面积为0．667，最佳阈值为65．3kU／L；Kaplan．Meier生存分析显示IMA水平与1年预后密切相关（P〈0．01）；Cox回归分析显示，引入相关危险因素校正后，IMA不是NSTEACS独立危险因素。

Two hundred and fourteen patients with non-ST-segment elevation acute coronary syndrome （NSTEACS） underwent percutaneous coronary intervention （PCI）. Serum ischemic modified albumin （IMA） levels were measured in patients at admission. The major adverse cardiac events （MACE） , including cardiac death, nonfatal myocardial infarction （MI） and recurrent ischemia leading to urgent revascularization were observed during 1-y period of follow-up. Receiver operating characteristic （ ROC ） curves, Kaplan-Meier analysis and Cox regression were used to assess the prognostic value of IMA for 1-y MACE. Twenty one patients experienced major adverse cardiac events during 1-y follow up period, including 6 cases of cardiac death, 8 cases of new or recurrent MI, 7 cases of target vessel/lesion revascularization or coronary artery bypass grafting （CABG）. ROC showed that the area under the ROC curve （ AUC ） was 0. 667, and when IMA was used to predict 1-y major adverse cardiac events, the cut-off value of 65.3 kU/L was most effective. Kaplan-Meier analysis showed that IMA was significantly correlated with the occurrence of 1-y MACE（P 〈 0. 01 ）. But Cox regression model showed that IMA levels were not independent risk factor for 1-y MACE in NSTEACS patients, when adjusted with other risk factors.