血清脂联素对急性冠脉综合征患者介入术后不良心血管事件的预测价值

Predictive Value of Serum Adiponectin for Adverse Cardiovascular Events in Patients with Acute Coronary Syndrome After Intervention Surgery

目的探讨血清脂联素(APN)对急性冠脉综合征(ACS)患者术后不良心血管事件的预测价值。方法纳入2020年4月至2022年4月在医院接受经皮冠状动脉介入治疗(PCI)的ACS患者为研究对象,于术前及术后7、30 d检测患者血清APN水平。术后随访12个月,统计术后不良心血管事件发生情况并将患者分为发生组、未发生组,比较两组术前及术后7、30 d的血清APN水平,绘制受试者工作特征(ROC)曲线,分析血清APN对ACS患者PCI后不良心血管事件的预测价值。结果完成随访工作共238例。238例ACS患者PCI后发生不良心血管事件共31例,占比13.03%。发生组2型糖尿病(T2DM)、合并冠状动脉微血管功能障碍(CMD)占比高于未发生组(P<0.05)。发生组术前及术后7、30 d血清APN水平逐渐降低,且发生组上述各时点血清APN水平均低于未发生组(P<0.05)。经多因素logistic回归分析,结果显示,血清APN低是ACS患者PCI后发生不良心血管事件影响因素(OR<1,P<0.05)。ROC曲线结果显示,术前及术后7、30 d血清APN预测ACS患者PCI后不良心血管事件的曲线下面积(AUC)均≥0.7,均有一定的预测价值。结论血清APN水平低是ACS患者PCI后发生不良心血管事件的影响因素,早期检测血清APN可以预测患者术后不良心血管事件发生风险。

Objective To investigate the predictive value of serum adiponectin(APN)for postoperative adverse cardiovascular events in patients with acute coronary syndrome(ACS).Methods Patients with ACS who underwent percutaneous coronary intervention(PCI)in the hospital from April 2020 to April 2022 were included as the study subjects.The serum APN levels of patients were measured before,7 and 30 days after the operation.All patients underwent a follow-up period of 12 months after surgery,and the incidence of adverse cardiovascular events was counted.Based on the results,the patients were divided into occurrence group and non-occurrence group.The serum APN levels were compared between the two groups before operation,7 and 30 days after operation,and the receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum APN for adverse cardiovascular events after PCI in ACS patients.Results A total of 238 patients completed follow-up work.A total of 31 adverse cardiovascular events occurred in 238 ACS patients after PCI,accounting for 13.03%.The proportion of type 2 diabetes(T2DM)and coronary microvascular dysfunction(CMD)in occurrence group was higher than that in non-occurrence group(P<0.05).The serum APN levels in occurrence group gradually decreased before surgery,7 and 30 days after surgery,and the serum APN levels in occurrence group were lower than those in non-occurrence group at all time points(P<0.05).Through multivariate logistic regression analysis,the results showed that low serum APN was a contributing factor to adverse cardiovascular events in ACS patients after PCI(OR<1,P<0.05).The results of ROC showed that the area under the curve(AUC)of serum APN predicting adverse cardiovascular events after PCI in ACS patients before surgery,7 and 30 days after surgery was≥0.7,which had certain predictive value.Conclusion Low serum APN level is a risk factor for adverse cardiovascular events in ACS patients after PCI,and early detection of serum APN can predict the risk of adverse cardiovascular events in patients after surgery.