可溶性ST2在STEMI患者经皮冠脉介入术后预后评估中的作用

Predictive Significance of Soluble ST2 for Clinical Outcomes in STEMI Patients Undergoing Percutaneous Coronary Intervention

目的 评估可溶性生长刺激表达基因2蛋白(s ST2)在ST段抬高型心肌梗死(STEMI)患者经皮冠脉介入术(PCI)后预后评估中的临床价值。方法 选取2016年1月-2019年1月在解放军总医院第七医学中心行PCI的173例STEMI患者,术前检测血清sST2,术后随访并采集患者1年主要心血管不良事件(MACE)情况,采用单因素和多因素分析评估STEMI患者PCI术前血清sST2水平与术后1年MACE之间的相关性。结果 高sST2组的1年MACE发生率(21. 8%)明显高于低s ST2组(10. 8%)(P=0. 04),其中两组在心源性死亡率和非致死性心肌梗死率方面无显著差异(P> 0. 05),而在再次血运重建率方面存在显著差异(14. 9%vs 2. 8%,P<0. 01),单因素和多因素分析显示血清sST2水平是STEMI患者PCI术后MACE的独立危险因素(HR 2. 07,95%CI 1. 12~5. 64,P<0. 01)。结论 PCI术前血清sST2水平升高的STEMI患者,PCI术后MACE风险增高。

To evaluate the association between soluble growth stimulation expressed gene 2(sST2)and prognosis in patients with ST-segment elevation myocardial infarction(STEMI)undergoing PCI.This study enrolled 173 patients with STEMI undergoing PCI in The Seventh Medical Center of Chinese PLA General Hospital from January 2016 to January 2019.Preoperative serum sST2 was detected for each patient.The primary endpoints of 12-months’follow-up were major adverse cardiovascular events(MACE).The association between serum sST2 and 12-months MACE was analyzed by using univariate and multivariate analysis.The 12-months MACE rate of patients with high sST2 level was significant higher than that of patients with low sST2 level(21.8%vs 10.8%,P=0.04).In details,the target vessel revascularization,but not cardiac death and non-fatal myocardial infarction,rate of patients with high sST2 level was significant higher than that of patients with low sST2 level(P<0.05).In the multivariate logistic regression model,serum sST2(HR 2.07,95%CI 1.12~5.64,P<0.01)were also a strongly independent predictor of MACE.Increased serum sST2 level is associated with the increased risk of MACE in STEMI patients undergoing PCI.