Correlation Between GGT Level And Coronary Artery Severity And Prognosis In STEMI Patients

Objective:To study the correlation between serum GGT level and the severity of coronary artery disease in STEMI patients,and the correlation between GGT level and the risk of MACEs in STEMI patients within 2 years.Methods:A collection of coronary angiography performed at the People’s Hospital of Xinjiang Uygur Autonomous Region from February 2015 to December 2018.According to the selection criteria and exclusion criteria,420 STEMI patients were included.Pearson correlation analysis or Spearman correlation analysis was used to analyze serum GGT and Correlation among body mass index,TG,HDL,ALT,AST,Gensini score,SYNTAX score,GRACE score.From June 2019 to November 2020,through the follow-up of all STEMI patients for at least 2 years,the occurrence of MACEs was recorded,and the Cox proportional hazard model was used to perform multivariate analysis on them to calculate the hazard ratio(hazard ratio,HR)and 95%confidence interval(CI).Based on the results of the multi-factor Cox proportional hazard model,a nomogram model for the risk of MACEs in STEMI patients within 2 years was constructed,and the AUC value of the predictive performance of GGT level on the risk of MACEs in STEMI patients within 2 years was obtained,and verified in the validation cohort.,Evaluate the performance of the nomogram through the degree of discrimination and the degree of calibration.Result:①There is a correlation between serum GGT and body mass index,TG,HDL,ALT,AST,Gensini score,SYNTAX score,GRACE score,and there is a negative correlation with HDL(r=-0.23,P=0.03),and Gensini score(r=0.56,P<0.01),body mass index(r=0.22,P<0.01),TG(r=0.31,P<0.01),ALT(r=0.26,P<0.01),AST(r=0.34,P<0.01),SYNTAX score(r=0.71,P<0.01),GRACE score(r=0.59,P<0.01)are positively correlated;②Multivariate COX regression analysis was performed on the data of the modeling cohort The results of multivariate COX regression analysis suggested that age,diabetes history,smoking history,GGT,cardiac function classification,Gensini score,GRACE risk score,and SYNTAX score were independent risk factors for MACEs in STEMI patients within 2 years(P<0.05).In the modeling cohort,age,diabetes history,smoking history,GGT,cardiac function classification,Gensini score,GRACE risk score,and SYNTAX score were used to predict the risk of MACEs in STEMI patients within 2 years.The above indicators predict the risk of MACEs in STEMI patients within 2 years.The AUC values are:age(AUC value=0.7012;95%CI:0.6346 to 0.7677).diabetes history(AUC value=0.6457;95%CI:0.5774 to 0.7141),Smoking history(AUC value=0.6880;95%CI:0.6209～0.7550),GGT(AUC value=0.7338;95%CI:0.6707～0.7970),cardiac function classification(AUC value=0.7073;95%CI:0.6434～0.7712),Gensini score(AUC value=0.7982;95%CI:0.7402～0.8563),GRACE risk score(AUC value=0.7153;95%CI:0.6499～0.7807),SYNTAX score(AUC value=0.7351;95%CI:0.6725～0.7978).Both are between 0.60 and 0.80.③ Based on the results of the above-mentioned multi-factor COX regression analysis,constructed and drawn a nomogram model to predict the risk of MACEs in STEMI patients within 2 years.In the modeling cohort,the constructed nomogram model predicted the occurrence of MACEs in STEMI patients within 2 years.The AUC value of risk is 0.914(95%CI:0.904～0.924).In the validation cohort,the constructed nomogram model predicts the AUC value of the risk of MACEs in STEMI patients within 2 years is 0.912(95%CI:0.849～0.975).And use Hosmer-Lemeshow test to draw a calibration chart.The calibration chart shows that the calibration curve of this prediction model is very close to the standard curve.The results can indicate that there is no big error between the predicted situation and the actual situation:modeling cohort(P=0.704),verification cohort(P=0.592).From the above results,GGT has good predictive value and can be used as a prognostic predictor of MACES in STEMI patients.Conclusions:Serum GGT level is significantly correlated with Gensini score and SYNTAX score of the severity of coronary artery disease in STEMI patients;serum GGT level is constructed in conjunction with age,diabetes history,smoking history,cardiac function classification,Gensini score,GRACE risk score,and SYNTAX score The model can be used as a prognostic evaluation tool to predict the occurrence of MACEs in STEMI patients within 2 years.