| Objective:To investigate the effect of serum uric acid level on major adverse cardiovascular events(MACE)within 1 month after emergency percutaneous coronary intervention(PCI)in elderly men with acute ST-segment elevation myocardial infraction(STEMI).Methods:A retrospective study was conducted on 198 elderly male patients with acute STEMI who were hospitalized in Cangzhou People’s Hospital from June2016 to September 2020.All patients were successfully treated with emergency PCI.The patients were followed up 1 month after surgery and were divided into a good prognosis group(no MACE group)and a poor prognosis group(MACE group)according to the occurrence of MACE.MACE were recorded:1.cardiac death;2.recurrent myocardial infarction;3.severe arrhythmias;4.recurrent angina pectoris;5.heart failure.Clinical data of the two groups were collected,including age,history of hypertension,history of diabetes,history of stroke,smoking history,systolic blood pressure(SBP)and diastolic blood pressure(DBP)at admission,heart rate at admission,serum potassium(K~+),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),serum uric acid level,serum creatinine,symptom onset to balloon time(SOTBT),coronary angiography results,etc.Statistical methods such as independent sample t-test,chi-square test,Pearson correlation analysis,binary logistic regression analysis and receiver operating characteristic were employed to analyze the data,so as to explore the effect of serum uric acid level on MACE within 1 month after emergency PCI in elderly men with acute STEMI.Results:1 A total of 198 elderly male patients with acute STEMI hospitalized in Cangzhou People’s Hospital from June 2016 to September 2020 were included.Follow-up was conducted one month after PCI,and 6 of them were lost to follow-up.Clinical data were collected from 192 patients with a total of41 MCAE(MACE group).Compared with the good prognosis group(no MACE group,n=151),the serum uric acid level,serum creatinine and SYNTAX score in MACE group were higher,and the differences were statistically significant(P<0.05).There were no statistically significant differences between the two groups in the following aspects:age,history of hypertension,history of diabetes,history of stroke,smoking history,SBP and DBP at admission,heart rate at admission,serum K~+,TC,TG,HDL-C,LDL-C and SOTBT(P>0.05).2 Pearson correlation analysis revealed that serum uric acid level was positively correlated with SYNTAX score(r=0.216,P<0.01).3 To reduce the omission of prognostic factors,independent sample t-test and independent variables with P<0.15 were included in the binary logistic regression model.Binary logistic regression analysis uncovered that serum uric acid level[odds ratio(OR=1.009)]and SYNTAX score[OR=1.068]were independent risk factors for MACE in elderly male acute STEMI patients after emergency PCI(P<0.05).4 ROC curve was applied to analyze the predictive effect of serum uric acid level on the occurrence of MACE within 1 month after emergency PCI in elderly men with acute STEMI.The area under the curve was 0.715(OR95%CI:1.003-1.014).When the optimal critical value of serum uric acid was363.50μmol/L,the prediction efficiency was the highest,the Youden index was0.352,the sensitivity was 0.537,and the specificity was 0.815.Conclusion:Serum uric acid level is an independent risk factor for MCAE within 1month after emergency PCI in elderly men with acute STEMI.The predictive power of ROC for MCAE in elderly male patients with acute STEMI was highest when the serum uric acid level was 363.50μmol/L. |
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