Association Of SST2 Level And Gensini Score With In-hospital Cardiovascular Events After PCI In Acute STEMI Patients

Objective:To investigate the predictive value of soluble growth stimulation expressed gene 2protein(sST2)level and Gensini score for in-hospital adverse cardiovascular events in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods:A total of 130 patients who were first diagnosed with STEMI and underwent emergency percutaneous coronary intervention(PCI)in the Department of Cardiology of Fenyang Hospital Affiliated to Shanxi Medical University from July 2021 to August2022 were selected as the research objects.The sST2 level of all subjects was detected within 24 hours after admission,and the Gensini score was recorded by coronary angiography(CAG).According to the occurrence of MACE events in hospital,they were divided into MACE+ group(13 cases)and MACE-group(117 cases).The differences in general clinical data and observation indicators sST2 and Gensini score between the two groups were compared.The receiver operating characteristic curve(ROC)was used to evaluate the value of each index in predicting the occurrence of MACE.Results:1.By analyzing the clinical data and observation indicators of the two groups,it can be concluded that compared with the MACE-group,the sST2 level and Gensini score were higher in the MACE+ group(P<0.05),and the difference was statistically significant;There were no significant differences in gender,age,history of hypertension,diabetes,smoking history,and NT-pro BNP,Alb,TC,TG,LDL-C,and HDL-C between the two groups(P>0.05).2.The statistically significant indicators in the above analysis were included in the multivariate Logistic regression analysis,and it can be concluded that: sST2 and Gensini scores were associated with in-hospital MACE in STEMI patients after emergency PCI[HR(95%CI)were 1.019(1.006-1.033),1.028(1.006-1.051),respectively,P<0.05].3.Pearson correlation analysis showed that serum sST2 level was positively correlated with Gensini score(r=0.381,P<0.001).4.ROC curve was drawn to analyze the predictive value of each index for in-hospital MACE in patients with acute STEMI.The results showed that: When sST2 was taken as 69.675ng/m L,its sensitivity and specificity to predict in-hospital MACE were 92.3% and 76.1%,respectively [AUC(95%CI)was 0.859(0.746-0.972),P<0.001].When the Gensini score was taken as 81 points,its sensitivity and specificity to predict in-hospital MACE were 84.6% and 64.1%,respectively [AUC(95%CI)was0.801(0.671-0.930),P<0.001].5.The Hanley-McNeil method was used to compare the area under the curve(AUC)between sST2 and Gensini score.The results showed that the combined detection of sST2 and Gensini score did not show unique advantages over single index,and there was no significant difference among different regions(P>0.05).Conclusion:The higher the serum sST2 level in acute STEMI patients,the more serious the degree of coronary artery disease.Serum sST2 and Gensini scores have certain predictive value for hospital MACE events after PCI in acute STEMI patients,which can provide prognostic information for patients,and help clinicians to make early diagnosis based on the above indicators,and reduce the occurrence of adverse cardiovascular events.