| Objective:To investigate the plasma monomer of C-reactive protein(mCRP)level area strain combined with three-dimensional speckle tracking(GAS)in patients with acute ST elevation myocardial infarction(STEMI)early diagnosis and prediction of the severity of coronary artery disease,and to investigate the correlation between plasma levels of mCRP,GAS in patients with ST elevation acute myocardial infarction prognosis.Methods:We enrolld150 STEMI patients admiteed in our hospital during the period from March 2015 to October 2016 as the experimental group,.All patients were admitted to examine plasma mCRP levels,perform electrocardiogram,record echocardiographic LVEF and LVEDd values.Besides,they shall be future examined 3D speckle tracking strain determination and measured the global area strain(GAS)within 12 hours of admission.Meanwhile,the coronary angiography shall be clearly diagnosed during hospitalization which the patients were divided into ST-segment elevation myocardial infarction group and control group,the control group was negative for results with coronary angiography.The acute ST-segment elevation myocardial infarction group was divided into three subgroups according to Gensini score:0<score ?40,40<score<80 and score?80,which were named as mild group,moderate group and severe group.30 patients with chest pain who were admitted to the hospital during the same period,but who had normal coronary angiography,were chosen as control group.We do analysis on the difference among the mCRP level,LVEF value and GAS value,and make the Pearson correlation analysis on the correlation among the mCRP level,GAS value and Gensini score.Meanwhile,we do the logistic regression analysis(quadratic nonconditional)and calculate the standard regression coefficients(Beta)and odds ratio(OR).The patients with ST segment elevation myocardial infarction were followed up,and the end point was recorded.The end point events were adverse cardiovascular events(MACE),the end point was AMI,intractable angina,heart failure,acute revascularization,cardiogenic shock,and cardiac death.Univariate and multivariate COX regression analysis of whether mCRP is an independent predictor of future MACE in patients with ST segment elevation myocardial infarction.Results:(1)the activity of plasma mCRP in patients with ST segment elevation myocardial infarction was significantly higher than that of the control group(P<0.05),and the LVEF and GAS values were lower than those in the control group(P<0.05).(2)with the increase of Gensini integral,the level of plasma mCRP increased,and there was statistical difference between the three subgroups(P<0.05),and the level of mCRP was positively related to the integral of Gensini(r=0.672,P<0.01),mCRP.(3)with the increase of Gensini integral,the GAS value decreased,and there was statistical difference in GAS value between the three subgroups(P<0.05),and the Gensini integral was negatively correlated with the GAS value(r=-0.56,P<0.01).(4)two classification of non conditional Logistic regression analysis showed that the activity of mCRP OR 1.617(95%CI=1:302-2.003,P<0.01);high density lipoprotein OR(95%CI=0.005=0.070?0.700,P<0.01);low density lipoprotein OR(95%CI=0.975 = 1.183?1.400,P<0.01);age the OR value is 1.056(95%CI=1.034?1.085,P<0.01).During the follow-up period,a total of 34 patients developed MACE,and the mCRP levels in the MACE group were significantly higher than those in the MACE group,and the LVEF and GAS values were significantly lower(p<0.05).Univariate and multivariate COX regression analysis showed that mCRP and GAS were risk factors for future MACE in patients with ST segment elevation myocardial infarction,and the mCRP level was an independent risk factor of[RR=1.06,(1.004,1.125),p=0.035].Conclusion:Plasma mCRP levels and GAS values may be ideal predictors of severity of coronary artery disease in patients with acute ST segment elevation myocardial infarction and predict adverse prognosis in patients with acute ST segment elevation myocardial infarction. |
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