[Risk Factors of Death in Patients with Acute ST-segment Elevation Myocardial Infarction after PCI and the Combined Application of CTRP-1 with GRACE Score in Prognosis Evaluation of PCI Treated Patients].

ABSTRACT

OBJECTIVE: To explore the risk factors of 12-month mortality in patients with acute ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI), and to evaluate the combined use of inflammatory factor complement Cq1/tumor necrosis factor-related protein-1 (CTRP-1) with global acute coronary event registration (GRACE) score in the patients with STEMI after PCI in terms of prognostic prediction for 12-month mortality risk. METHODS: 326 acute STEMI patients were included retrospectively, with 33 patients in the death group and 293 patients in the survival group. Clinical data of patients and serum CTRP-1 concentration detected by enzyme-linked immunosorbent assay (ELISA) were collected, and all patients were evaluated by GRACE score. The cut-off point of CTRP-1 for predicting mortality was determined by receiver operating characteristic (ROC) curve. Cox regression model was used to analyze the risk factors of death. The predictive value of CTRP-1 combined with GRACE score was tested by Kaplan-Meier survival analysis. RESULTS: Compared with the survival group, the average arterial pressure, left ventricular ejection fraction (LVEF) and left main lesion rate were lower, creatinine and troponin T were higher in the death group (P < 0.05). The mass concentration of CTRP-1 in the death group was higher than that in the survival group (P < 0.001). The proportion of patients in the high-risk group of GRACE score was 66.7% in the death group and 20.1% in the survival group. The area under the ROC curve of CTRP-1 was 0.874 (P < 0.001), and the sensitivity and specificity of predicting death were 92.5% and 73.6% respectively with the cut-off point of CTRP-1 187.9 ng/mL. Cox regression model showed that mean arterial pressure, LVEF, GRACE score and high CTRP-1 (>187.9 ng/mL) were independent risk factors for predicting death. Survival analysis showed that the cumulative survival rate of patients with high CTRP-1 level was lower than low CTRP-1 level in the high-risk group of GRACE score (P < 0.001). CONCLUSIONS: Mean arterial pressure, LVEF value, GRACE score and CTRP-1 are risk factors for predicting mortality. Combined application of CTRP-1 with GRACE score has clinical value in prognostic evaluation of acute STEMI patients.