血清Lp(a)联合Gensini评分对ACS患者PCI术后短期预后的评估价值

The Value of Serum Lp(a)Combined with Gensini Score in Evaluating the Short-term Prognosis of ACS Patients after PCI

目的探讨血清脂蛋白(a)(lipoproteina,Lpa)联合Gensini评分对急性冠脉综合征Acute coronary syndrome ACS)患者接受经皮冠脉介入治疗(percutaneous coronary intervention,PCI)后的短期(28天)内预测重大心血管不良事件(MACE)的临床价值,并探讨其是否可作为MACE的预测指标。方法纳入2023年6月至2024年12月期间,于长春市中心医院行PCI的115例ACS患者,按术后28天内MACE发生与否分为MACE组(n=23)与非MACE组(n=88)。通过Spearman相关及逻辑回归分析评估风险因素与MACE的关系,ROC曲线分别评估Lp(a)、Gensini评分及两者联合的预测能力。结果共随访115例患者,4人失访,111人按术后28天内MACE发生与否分为MACE组(n=23)与非MACE组(n=88)。MACE组Gensini评分、血清Lp(a)浓度均高于非MACE组(P<0.05)。Logistic回归分析与Spearman相关性分析结果显示Gensini评分、Lp(a)均为影响ACS患者PCI术后预后的风险因素且呈正相关。Gensini评分、Lp(a)对ACS患者行PCI术后短期预后的最佳阈值为293.95、74.00,两者独立及相互联合的AUC值为0.78、0.71、0.84。结论Lp(a)、Gensini评分是ACS患者PCI术后28天内发生MACE的风险因素,且可作为MACE预测因子,两者联合对PCI短期预后的预测准确性较高。

Objective The clinical value of serum lipoprotein(a)(Lp(a))combined with Gensini score in predicting major adverse cardiovascular events(MACE)within 28 days after percutaneous coronary intervention(PCI)in patients with acute coronary syndrome(ACS)was discussed,and whether it could serve as a predictive indicator for MACE was explored.Methods During the period from June 2023 to December 2024,115 ACS patients who underwent PCI at the Central Hospital of Changchun were divided into the MACE group(n=23)and the non-MACE group(n=88)based on the occurrence of MACE within 28 days postoperatively.Risk factors related to MACE were evaluated through Spearman correlation and logistic regression analyses,while the predictive abilities of Lp(a),Gensini score,and their combination were assessed using ROC curves.Results A total of 115 patients were followed up,with 4 lost to follow-up.Among them,111 patients were divided into the MACE group(n=23)and the non-MACE group(n=88)based on whether MACE occurred within 28 days after surgery.Gensini score and serum Lp(a)concentration in the MACE group were both higher than those in the non-MACE group(P<0.05).Logistic regression analysis and Spearman correlation analysis showed that Gensini score and Lp(a)were both risk factors affecting the prognosis of ACS patients after PCI and were positively correlated.The optimal threshold values of Gensini score and Lp(a)for short-term prognosis after PCI in ACS patients were 293.95 and 74.00,respectively.The independent and combined AUC values of Gensini score and Lp(a)for short-term prognosis after PCI in ACS patients were 0.78,0.71,and 0.84.Conclusion Lp(a)and Gensini score are risk factors for MACE occurrence within 28 days after PCI in ACS patients,and they can serve as predictors for MACE.The combination of the two has higher predictive accuracy for the short-term prognosis of PCI.