In-hospital major adverse cardiovascular events after primary percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction: a retrospective study under the China chest pain center (standard center) treatment system.

BACKGROUND: Patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) are at high risk of major adverse cardiovascular events (MACE) despite timely treatment. This study aimed to investigate the independent predictors and their predictive value of in-hospital MACE after primary PCI in patients with acute STEMI under the China chest pain center (standard center) treatment system. METHODS: We performed a single-center, retrospective study of 151 patients with acute STEMI undergoing primary PCI. All patients were treated under the China chest pain center (standard center) treatment system. The data collected included general data, vital signs, auxiliary examination results, data related to interventional therapy, and various treatment delays. The primary endpoint was the in-hospital MACE defined as the composite of all-cause death, stroke, nonfatal recurrent myocardial infarction, new-onset heart failure, and malignant arrhythmias. RESULTS: In-hospital MACE occurred in 71 of 151 patients with acute STEMI undergoing primary PCI. Logistic regression analysis showed that age, cardiac troponin I (cTnI), serum creatinine (sCr), multivessel coronary artery disease, and Killip class III/IV were risk factors for in-hospital MACE, whereas estimated glomerular filtration rate (eGFR), left ventricular ejection fraction (LVEF), systolic blood pressure (SBP), diastolic blood pressure (DBP), were protective factors, with eGFR, LVEF, cTnI, SBP, and Killip class III/IV being independent predictors of in-hospital MACE. The prediction model had good discrimination with an area under the curve = 0. 778 (95%CI: 0.690-0.865). Good calibration and clinical utility were observed through the calibration and decision curves, respectively. CONCLUSIONS: Our data suggest that eGFR, LVEF, cTnI, SBP, and Killip class III/IV independently predict in-hospital MACE after primary PCI in patients with acute STEMI, and the prediction model constructed based on the above factors could be useful for individual risk assessment and early management guidance.

Serum miRNA-203 as a Novel Biomarker for the Early Prediction of Acute ST-elevation Myocardial Infarction.

Existing markers of myocardial infarction have limited diagnostic value for infarction, so it is necessary to identify new markers of infarction. To study the predictive value of serum miRNA-203 for acute ST-elevation myocardial infarction. Seventy patients with STEMI who were diagnosed in Hefei Second People's Hospital from December 2020 to December 2021 were selected, and 35 patients with transient chest pain who were hospitalized for other diseases in the Cardiology Department of our hospital during the same period were selected as the control group. The sera of the two groups of patients were collected, and a miRNA-203 semiquantitative experiment was performed. The miRNA-203 level in the STEMI group was higher than that in the control group. The AUC area of miRNA-203 in predicting STEMI was 0.912. Logistic regression analysis showed that miRNA-203 and white blood cell counts were independent risk factors for STEMI (P<0.05), and their ORs (95% CI) were 3.913 (1.574-9.728) and 2.13 (1.247-3.641), respectively. The present study reveals that miRNA-203 could be a possible candidate for a novel biomarker in the early prediction of STEMI.