Analysis of biomarkers for predicting left ventricular remodeling after successful revascularization of acute myocardial infarction / 上海交通大学学报（医学版）

ABSTRACT

Objective: To investigate the correlation between the biomarkers and left ventricular remodeling (LVR) in patients after acute myocardial infarction (AMI). Methods: 220 patients with AMI who were admitted in the Department of Cardiology of the Shanghai Sixth People's Hospital from January 1st, 2015 to January 1st, 2016 and received successful primary percutaneous coronary intervention were included in this study sequentially. AMI patients due to right coronary artery were excluded. LVR after AMI was defined as more than 20% increase of the left ventricular end diastolic volume (LVEDV) measured by echocardiogram in 1-year-follow-up compared with LVEDV at admission. Patients were divided into LVR group and non-LVR group. The differences of myocardial injury markers and inflammatory factors between the two groups were compared, and the correlation between LVR and the biomarkers was analyzed. Results: Compared with the non-LVR group, the cTnI (serum cardiac troponin I), CKMB (creatine kinase MB) and myoglobin levels at admission and peaks, as well as neutrophil to monocyte ratio and neutrophil to lymphocyte ratio (NLR) in the LVR group were increased significantly (all P<0.05). There was no significant difference in proBNP (brain natriuretic peptide precursor) and BNP levels between the two groups. Logistic regression analysis showed that cTnI and NLR at admission were correlated well with LVR. ROC curve analysis showed that the area under the cTnIadmission curve (AUC) was 0.704, and the sensitivity and specificity of cTnIadmission to predict LVR after AMI were 69.2% and 64.3% respectively, when 9.14 μg/L was chosen as the cut-off point. The area under the NLR curve (AUC) was 0.664, and the sensitivity and specificity of NLR were 70.6% and 60.2% respectively, when 5.87% was chosen as the cut-off point. Conclusion: The increased levels of cTnI and NLR at admission in patients with AMI are independent predictors of LVR.