缺血修饰白蛋白与急性ST段抬高型心肌梗死远期心血管事件的相关性

Prognostic value of ischemic modified albumin for patients with acute ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention

目的探讨缺血修饰白蛋白（IMA）与急性ST段抬高型心肌梗死远期心血管事件的相关性。方法选择急性ST段抬高型心肌梗死患者125例，所有患者入院时测定IMA，随访1年主要不良心血管事件。采用受试者工作特征（ROC）曲线、Kaplan—Meier生存分析及Cox回归方法分析IMA与ST段抬高型心肌梗死预后的关系。结果随访1年中，22例发生主要不良心血管事件（事件组），事件组IMA水平明显高于非事件组[（85±25）U／ml比（66±27）U／ml，P〈0．01]。ROC曲线分析示IMA预测1年主要不良心血管事件的曲线下面积为0．698，最佳阈值为78．92U／ml；Kaplan—Meier生存分析显示，IMA水平升高与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是急性心肌梗死患者1年主要不良心血管事件发生的独立危险因素[风险比（HR）=1．07，95％置信区间：1．03～1．12，P=0．003]。结论血IMA水平与急诊介入治疗ST段抬高型心肌梗死患者远期不良心血管事件有关，可能是重要的预测因素。

Objective To evaluate the prognostic value of ischemic modified albumin （IMA） for patients with acute ST-elevation myocardial infarction （STEMI） receiving primary percutaneous coronary intervention. Methods All 125 patients with STEMI were enrolled. The primary endpoints were major adverse cardiac events （MACE）. Receiver operating characteristic （ROC） curves, Kaplan-Meier analysis and Cox regression were used to assess the prognostic value of IMA for 1 year MACE. Results Of 125 patients, 22 patients experienced MACE dur- ing the 1 year follow up period. ROC showed that IMA were predictors of 1 year major adverse cardiac events. The area under curve was 0. 698. Kaplan-Meier analysis showed that IMA had effective prognosis value of 1 year MACE. When IMA was added to a Cox regression model including clinical background factors. IMA levels were independently associated with adverse prognosis[ hazard ratio（HR） = 1.07, 95% confidence interval： 1.03-1.12, P = 0. 003 ]. Conclusion IMA has an effective prognosis value for 1 year MACE for patients with acute ST-elevation myocardial infarction receiving primary PCI.