The Relationship Of Serum Clusterin Levels And Left Ventricular Remodeling After Acute Myocardial Infarction

Objective: The aim of this study was to investigate the relationship between serum CLU level and left ventricular remodeling(LVR)in patients after acute myocardial infarction(AMI).Methods: A total of 70 patients with ST-segment elevation myocardial infarction(STEMI)in the Second Hospital of Hebei Medical University from June 2017 to June 2018 were collected.All of them arrived at hospital within 12 hours after the onset of the symptoms,and had received emergency PCI to achieve TIMI II or TIMI III flow.We measured the serum CLU levels of them by ELISA.The figure of Echocardiography were recorded within 48 hours and 6 months after onset of symptoms.The figure of Echocardiography conclude some results,such as Left ventricular end-diastolic dimension(LVEDD),Left ventricular end-diastolic volume(LVEDV),Left ventricular ejection fraction(LVEF),Interventricular septal depth(IVSD),Left ventricular posterior wall depth(LVPWD).The rate of change of LVEDV?15% was considered as left ventricular remodeling,and thus the STEMI group was divided into remodeling and non-remodeling group.The difference of serum CLU levels between the two groups was compared.Another 30 patients who had normal coronary angiography but still had symptoms such as chest pain,were selected as control group.To compare the serum CLU levels between AMI group and control group,t test was used to compare the mean,and chi-square test was used to compare the rates.Correlations between two variables were assessed by using Pearson correlation analysis.Association between left ventricular remodeling and clinical/biochemical indicators that conclude age,gender,presence of hypertension,blood lipid,blood glucose,whether LAD is culprit,troponin-I and serum CLU levels,were analyzed by Logistic regression analysis.A level of P<0.05 was considered statistically significant.Statistical analysis were performed by using SPSS 21.0 for Windows.Results:1.There were no difference between AMI group and control group in age,gender,BMI,the prevalence of hypertension,prevalence of diabetes,smoking history,prevalence of coronary heart disease.And there were no difference between these two groups in WBC,PLT,fasting plasma glucose(FPG),the level of serum triglycerides(TG),serum total cholesterol(TC),serum high-density lipoprotein(HDL).The level of serum low-density lipoprotein(LDL)in AMI group(3.68±1.04mmol/L)was higher than that in control group(2.59±0.69mmol/L,P<0.05).2.There were no difference between the remodeling and non-remodeling group in age,gender,BMI,the prevalence of hypertension,prevalence of diabetes,history of smoking,family history of coronary heart disease,whether LAD is culprit and medication.And there were no difference between these two groups in WBC,PLT,fasting plasma glucose(FPG),TG level,TC level,HDL level,LDL level,creatine kinase isoenzymes,troponin-I,CRP.3.The serum level of CLU in AMI group(122.25±11.35ug/ml)was higher than that in control group(84.05±17.99ug/ml,P<0.05).The serum level of CLU in non-remodeling group(128.01±7.72ug/ml)was higher than that in remodeling group(113.61±10.46ug/ml,P<0.05).4.The LVEDV and LVEF were no difference between the remodeling and non-remodeling group within 48 hours of onset.At 6 months after AMI,LVEDV of patients in remodeling group were significantly higher than that in non-remodeling group and LVEF of patients in remodeling group was significantly lower than that in non-remodeling group.At 6 months after AMI,IVSD.LVPWD were no difference between the remodeling and nonremodeling group.At 6 months after AMI,?LVEDV(38.34±10.21ml)in remodeling group was significantly higher than that in non-remodeling group(4.42±3.70 ml,P<0.05).At 6 months after AMI,?LVEF(-16.42±7.93%)in remodeling group was significantly lower than that in non-remodeling group(-1.76±5.32%,P<0.05).5.The level of CLU was negatively correlated with the rate of change of LVEDV(r=-0.625,P< 0.05),and positively correlated with the rate of change of LVEF(r =0.394,P<0.05).6.In Logistic regression analysis of all patients with AMI,only the serum CLU level was significantly associated with left ventricular remodeling(OR=0.602,P<0.01).Conclusions: CLU level in AMI group was higher than that in control group,and it is higher in the non-remodeling group than that in remodeling group.It is suggested that CLU level may suppress left ventricular remodeling(LVR)in patients after acute myocardial infarction(AMI)as a protective factor.