关键词: 危险因素, 预后, 心型脂肪酸结合蛋白, ST 段抬高型心肌梗死, 经皮冠状动脉介入治疗

Abstract: Objective To observe the relationship between serum level of H-FABP before percutaneous coronary intervention (PCI) and prognosis in patients with ST-segment elevation myocardial infarction (STEMI). Methods A total of 104 cases were recruited in this study. PCI was performed 12 h after onset. The concentration of H-FABP was detected before operation. Gensini score system was used to calculate the integral of all patients after coronary angiography. According to Gensini score, patients were divided into three groups, 34 cases in group A (8≤Gensini scores＜41), 34 cases in group B(41≤Gensini scores＜64) and 36 cases in group C (Gensini scores≥64). Indicators were analyzed statistically including systolic blood pressure (SBP), diastolic blood pressure (DBP), smoking history, H-FABP, left ventricular ejection fraction (LVEF), total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), fasting blood sugar, diabetes (DM) and hypertension. The patients were followed up for 12 months after operation. According to the occurrence of major adverse cardiovascular events (MACE), patients were divided into MACE group and non- MACE group.The related factors of two groups were statistically analyzed. The multivariate Logistic regression analysis was used to screen the risk factors of MACE for patients with STEMI after emergency PCI. Results There is a gradually increasing tendency in total cholesterol levels among three A, B and C groups (P＜0.05). LVEF values were lower in B group and C group than that of A group (P＜0.05). There were no significant differences in levels of SBP, DBP, H-FABP, TG, HDL-C, LDL-C, fasting plasma glucose and smoking history, DM, and hypertension between three groups (P＞0.05). In 12-month follow-up, the proportion of STEM combined with DM, the time from onset to PCI, the level of TC, the level of H-FABP before operation and Gensini score were significantly higher in MACE group than those of non-MACE group (P＜0.05). Logistic regression
analysis showed that STEM combined with DM, higher serum level of H-FABP before operation were risk factors of MACE in 12-month after operation (P<0.05). Conclusion For patients with acute STEM combined with diabetes and elevated preoperative serum level of H-FABP, be alert to the occurrence of MACE in 12-month after PCI

Key words: risk factors, prognosis, heart fatty acid binding protein, ST elevation myocardial infarction, percutaneous coronary intervention