| Objective:By analyzing the occurrence of fragmented QRS(f QRS)in patients with acute STsegment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI)and detecting soluble growth-stimulating gene 2 protein(s ST2)and N-terminal pro-B-type natriuretic peptide(NT-pro BNP)levels in serum,to discuss the predictive value of f QRS,s ST2,NT-pro BNP and their combination for major adverse cardiovascular events(MACE)after PCI in acute STEMI patients.Methods:From October 2021 to April 2022,we selected 130 patients who presented to the Chest Pain Center of the Second Hospital of Shanxi Medical University with acute STEMI for PCI and were hospitalized.All patients underwent ECG examination after PCI,and the presence or absence of f QRS was analyzed.Venous blood was collected and sent to the clinical laboratory of our hospital for determination of s ST2 and NT-pro BNP levels.All patients were followed up for 6 months.Unstable angina,recurrent myocardial infarction,heart failure,malignant arrhythmia,and cardiac death were defined as major cardiovascular event endpoints.During follow-up,12 patients were lost to follow-up and118 patients were finally enrolled.According to the occurrence of endpoint events,the patients were divided into MACE group(n=40)and non-MACE group(n=78).SPSS26.0 software was used to analyze the expression of f QRS,s ST2 and NT-pro BNP and their predictability for MACE between different groups.Results:1.Compared with the non-MACE group,the MACE group had a higher incidence of f QRS,higher levels of s ST2,NT-pro BNP,c Tn I,MYO,and CK-MB,and lower levels of LVEF and LVEDD,with statistical significance(P<0.05);The Gensini score of MACE group was higher,and the proportion of Killip grade > Grade II was higher,with statistical significance(P < 0.05).2.Binary logistics regression showed that f QRS,s ST2 and NT-pro BNP were independent predictors of MACE in patients with acute STEMI.The predictive ability of each indicator to MACE was evaluated by drawing receiver operating characteristic(ROC)curve and comparing area under curve(AUC).The AUC values of f QRS,s ST2,NT-pro BNP and their combination were 0.797,0.871,0.831 and 0.925,respectively.The Delong test found that the AUC value of the combined detection of the three indicators was significantly different from that of any single index,with statistical significance(P <0.05).and pairwise comparison of the three indicators revealed that there was no significant difference in AUC values between each single index(P > 0.05).Conclusion:FQRS,s ST2 and NT-pro BNP all have predictive value for the occurrence of MACE in acute STEMI patients within 6 months.Patients with acute STEMI have f QRS on the ECG after PCI and high levels of s ST2 and NT-pro BNP may be related to MACE events,and the predictive value of the combination of the three is better than that of each single index. |
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