血清抗菌肽37、HDAC4对急性心肌梗死患者PCI术后发生不良心血管事件的预测价值

Predictive value of serum antimicrobial peptide 37 and histone deacetylase 4 for occurrence of major adverse cardiovascular events after PCI in patients with acute myocardial infarction

目的 探讨血清抗菌肽LL-37、组蛋白去乙酰化酶(HDAC)4对急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后发生主要不良心血管事件(MACE)的预测价值。方法 选取2021年1月至2023年5月在潍坊市人民医院急诊内科行PCI术的AMI患者240例,根据PCI术后3个月是否发生MACE分为MACE组和non-MACE组。采用酶联免疫吸附试验检测血清LL-37、HDAC4水平。采用多因素Logistic回归分析PCI术后AMI患者发生MACE的影响因素。采用受试者工作特征(ROC)曲线分析血清LL-37、HDAC4单项及联合检测对PCI术后AMI患者发生MACE的预测价值。结果 240例AMI患者PCI术后3个月有66例发生MACE(MACE组),其余174例纳入non-MACE组,MACE发生率为27.50%。与non-MACE组比较,MACE组血清LL-37、HDAC4水平降低(P<0.05)。年龄增加、KILLIP分级≥Ⅱ级是AMI患者PCI术后发生MACE的独立危险因素(P<0.05),左心室射血分数、LL-37和HDAC4水平升高是保护因素(P<0.05)。血清LL-37联合HDAC4预测AMI患者PCI术后发生MACE的曲线下面积为0.864,大于血清LL-37、HDAC4单独预测的0.778、0.779(P<0.05)。结论 血清LL-37、HDAC4联合检测对AMI患者PCI术后发生MACE的预测价值较高。

Objective To investigate the predictive value of serum antimicrobial peptide LL-37 and histone deacetylase 4(HDAC4)on the occurrence of major adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI)in the patients with acute myocardial infarction(AMI).Methods A total of 240 AMI patients with PCI in the department of emergency internal medicine of Weifang Municipal People′s Hospital from January 2021 to May 2023 were selected and divided into the MACE group and the non-MACE group according to whether or not MACE occurred in 3 months after PCI.Serum LL-37 and HDAC4 levels were measured by ELISA.The multivariate Logistic regression was used to analyze the influencing factors of MACE occurrence after PCI in the patients with AMI.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum LL-37 and HDAC4 single detection and their combined detection in predicting the MACE occurrence.Results Among 240 AMI patients of 3 months after PCI,MACE occured in 66 patients(MACE group),with occurence rate of MACE of 27.50%,and the remaining 174 patients were included in non-MACE group.Compared with the non-MACE group,serum LL-37 and HDAC4 levels in the MACE group were reduced(P<0.05).The age increase and KILLIP grade≥gradeⅡwere the independent risk factors for MACE occurrence after PCI in AMI patients(P<0.05),and the increase levels of left ventricular ejection fraction,LL-37 and HDAC4 were the protective factors(P<0.05).The area under the curve of serum LL-37 combined with HDAC4 for predicting the occurrence of MACE after PCI in AMI patients was 0.864,which was greater than 0.778 and 0.779 in serum LL-37 and HDAC4 levels for single prediction(P<0.05).Conclusion The combination detection of serum LL-37 and HDAC4 has a high predictive value for the MACE occurrence after PCI in the patients with AMI.