Abstract: Abstract Objective: To evaluate the prognostic value of the plasma levels of type II secretory phospholipase A2 in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention. Methods: A total of 223 patients with AMI who underwent primary PCI were divided into MACE group（95） and no MACE group （128）on the basis of whether happening MACE after 2 years’ follow-up. Compared the baseline characteristics, plasma levels of sPLA2 and angiographic characteristics and procedure related data in patients with PCI of the two groups. Cox's proportional hazard regression analysis was used to assessed the predictive value for MACE during the follow-up period and the Kaplan–Meier method was applied in survival analysis according to the levels of sPLA2. Results: 95 patients happened MACE during the follow-up period. The proportion of male, type 2 diabetes mellitus, number of white blood cells, BUN, Glucose, CK, CK-MB, sPLA2, multiple (≥double-vessel CAD) coronary arteries with stenosis, symptom-to-balloon time and no-reflow after PCI were significantly higher in MACE group than no MACE group while the left ventricular ejection fraction was lower. Multivariate forward stepwise Cox proportional hazard regression analysis showed that sPLA2 >5.48μg/L(RR: 3.23, 95% CI: 1.24-12.36, P<0.001), diabetes mellitus (RR: 2.78, 95% CI: 1.52-7.24, P<0.001), multiple coronary arteries with stenosis (RR: 2.37, 95% CI: 1.66-6.79, P<0.001)and left ventricular ejection fraction <50%(RR: 1.74, 95% CI: 1.07-2.94, P=0.037) were predictors of subsequent MACE. Conclusion: The present study showed that elevation of circulating levels of sPLA2 in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention was associated with the poor prognosis.

Key words: acute myocardial infarction, percutaneous coronary intervention, sPLA2, prognosis