ABSTRACT
Objective:To investigate the correlation between serum C1q/tumor necrosis factor-associated protein 3 (CTRP3), soluble growth stimulation expression gene 2 protein (sST2), Elabela and prognosis in patients with acute ST-segment elevation myocardial infarction (ASTEMI) after percutaneous coronary intervention (PCI).Methods:The clinical data of 118 ASTEMI patients underwent PCI from March 2019 to March 2021 in Beijing Luhe Hospital, Capital Medical University were retrospectively analyzed. According to whether major adverse cardiovascular events (MACE) occurred within 90 d, the patients were divided into MACE group (36 cases) and non-MACE group (82 cases). The levels of CTRP3, sST2 and Elabela were detected by enzyme linked immunosorbent assay, and the patients were divided into high CTRP3 group and low CTRP3 group, high sST2 group and low sST2 group, high Elabela group and low Elabela group according to the median, there were 89 cases in each group. MACE was the end point event. Kaplan-Meier survival curve was drawn, and compared by log-rank test. Multivariate Cox regression was used to analyze the influencing factors of MACE after PCI in patients with ASTEMI. Receiver operating characteristic (ROC) curve was drawn to analyze the prediction efficiency of MACE.Results:The sST2 in MACE group was significantly higher than that in non-MACE group: (49.56 ± 17.67) μg/L vs. (30.76 ± 12.83) μg/L, the CTRP3 and Elabela were significantly lower than those in non-MACE group: (0.82 ± 0.42) μg/L vs. (2.02 ± 0.58) μg/L and (17.66 ± 3.85) μg/L vs. (21.84 ± 3.18) μg/L, and there were statistical differences ( P<0.01). The incidence of MACE in low CTRP3 group was significantly higher than that in high CTRP3 group: 49.15% (29/59) vs. 11.86% (7/59), the incidence of MACE in lowe Elabela group was significantly higher than that in high Elabela group: 42.37% (25/59) vs. 18.64% (11/59), and there were statistical differences ( χ2 = 19.35 and 7.84, P<0.01); the incidence of MACE in high sST2 group was significantly higher than that in low sST2 group: 38.98% (23/59) vs. 22.03% (13/59), and there was statistical difference ( χ2 = 4.00, P<0.05). The time from admission to MACE was defined as the survival time. Kaplan-Meier survival curve analysis result showed that the survival time in high CTRP3 group was significantly longer than that in low CTRP3 group: (81.02 ± 3.23) d vs. (56.31 ± 4.74) d, the survival time in low sST2 group was significantly longer than that in high sST2 group: (74.52 ± 3.87) d vs. (61.12 ± 5.07) d, the survival time in high Elabela group was significantly longer than that in low Elabela group: (77.95 ± 3.48) d vs. (58.64 ± 4.89) d, and there were statistical differences ( P<0.05). Multivariate Cox regression analysis result showed that the LVEF, TnI, CTRP3, sST2 and Elabela were independent influencing factors of MACE after PCI in patients with ASTEMI ( HR = 1.632, 1.124, 0.712, 1.482 and 0.676; 95% CI 1.531 to 3.271, 1.012 to 1.482, 0.547 to 0.842, 1.063 to 1.852 and 0.536 to 0.725; P<0.01). ROC curve analysis result showed that the cut-off values of CTRP3, sST2 and Elabela in prediction MACE after PCI in patients with ASTEMI were 0.79, 52.17 and 16.82 μg/L respectively, areas under curve were 0.833, 0.732 and 0.739 respectively. Conclusions:CTRP3, sST2 and Elabela can be used as indicators to predict the early prognosis of ASTEMI patients after PCI.