| Background: Acute coronary syndrome(ACS) is a serious clinical types of coronary artery disease, it including unstable angina pectoris(UAP), non-ST-segment elevation myocardial infarction(NSTEMI) and ST segment elevation myocardial infarction(STEMI).As people’s living standards improve,the incidence of ACS is rising.It has a high morbidity and mortality,and brought a heavy burden to social and economic development.In recent years,evidence-based medicine shows opening the stenosis as soon as possible could protect the cardiac function in the greatest degree,reduce the mortality and improve the prognosis.At present, percutaneous coronary intervention(PCI) has become the major therapy in myocardial ischemia and reperfusion.Follistatin-like protein 1(follistatin-like 1, FSTL1) is a secreted glycoprotein by myocardial cells,which the level increases significantly during myocardial ischemia,cardiac pressure overload conditions. In recent years, studies have shown that correlation is found between FSTL1 levels and disease severity in patients with ACS,but the study of the alteration and significance of serum concentrations of FSTL1 before and after PCI in patients with acute coronary syndrome is not enough.Objective: To investigate the value of FSTL1 estimating the PCI therapeutic effect and prognosis in ACS patients by checking the alteration serum concentrations of FSTL1 before and 24 h,7d after PCI,then comparing them with sensitive troponin I(c Tn I),high-sensitivity C-reactive protein(hs-CRP)and brain natriuretic peptide(BNP) and observing the Major Adverse Cardiac Events(MACE) by following up.Methods: From September 2013 to August 2014,Selecting 50 patients who were diagnosis of ACS and successful treated by PCI,selecting another 50 patients who were diagnosis of ACS and not treated by PCI as a control group. Serum concentrations of FSTL1 and hs-CRP were determined by enzyme linked immunosorbent assay(ELISA)before and 24 h,7d after PCI of PCI group. Concentrations of c Tn I and BNP were determined by immune fluorescence method before and 24 h,7d after PCI of PCI group.Concentrations of the same items in control group were determined before and 24 h,7d after treatment.Comparing the result of all the items above and exploring theircorrelations. Major Adverse Cardiac Events were observed in six months follow up.Results(1) Patients in PCI group’s serum concentrations of FSTL1 at 24 h,7d after PCI decreased significantly than before, P<0.05.(2) There was no diffenence that patients in control group’s serum concentrations of FSTL1 before and 24 h after treatment,P>0.05.But they decreased 7d later, P<0.05.(3) There was no diffenence between PCI group and control group in the serum concentrations of FSTL1 before treatment,P>0.05.But the control group’s serum concentrations of FSTL1 at 24 h,7d after treatment were higher than the PCI group’s, P<0.05.(4) The alteration of serum concentrations of FSTL1 before and after PCI were positively correlated with the alteration of level of c Tn I and BNP, P<0.05. The alteration of serum concentrations of FSTL1 before and after PCI were not positively correlated with the alteration of level of hs-CRP, P>0.05.(5)During 6 months’ visit,8 patients suffered from MACE,6 events happened in control group and 2 events happened in PCI group. MACE took place in those patients whose serum concentrations of FSTL1 before and 24 h,7d after PCI were much higher, P<0.05.Conclousion:(1) Comparing with drug treatment,PCI could better reperfusion myocardium,reducing the incidence of MACE in patients with ACS.(2) Serum concentrations of FSTL1 after PCI decreased significantly than before and the alteration of serum concentrations of FSTL1 were positively correlated with the alteration of level of c Tn I and BNP,it is suggested that FSTL1 may have some value in the assessment of PCI effect in patients with ACS.(3) The high serum concentrations of FSTL1 during treatment may be risk factors for patients with ACS.FSTL1 has clinical value in predicting the prognosis of patients with ACS. |
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