Abstract:Objective: To investigate the global acute coronary event registration score (GRACE) combined with serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and lipoprotein-associated phospholipase A2 (Lp-PLA2) levels in patients with acute myocardial infarction (AMI) application value in the prediction of cardiovascular adverse events (MACE) after cortical coronary intervention (PCI). Methods: A total of 189 patients with acute myocardial infarction in our hospital (from November 2016 to March 2018) were enrolled. All patients were followed up for 6 months after PCI. 56 patients with myocardial infarction with MACE were assigned to MACE group, and the rest did not have MACE. Patients with myocardial infarction were set to non-MACE group. The general conditions of the two groups (gender, age, BMI, diastolic blood pressure, systolic blood pressure, history of heart failure, history of diabetes, heart rate) and GRACE scores were measured. Serum NT-proBNP levels were determined by double-antibody sandwich immunofluorescence assay. Serum Lp-PLA2 levels were determined by immunosorbent assay. The general conditions, GRACE scores, serum NT-proBNP, and Lp-PLA2 levels were statistically analyzed, and the risk factors associated with MACE in patients with acute myocardial infarction were statistically analyzed. Results: There were no significant differences in gender, age, BMI, diabetes history and non-MACE between the MACE group (P>0.05). The diastolic blood pressure, heart rate and heart failure and systolic blood pressure in the MACE group were lower than those in the non-MACE group(32.14%), higher than the Non-MACE group (3.76%) (P<0.05); GRACE score and serum NT-proBNP, Lp-PLA2 levels in MACE group were significantly higher than non-MACE group (P<0.05); Logistic multiple linear regression analysis showed that GRACE score ≥ 140 points, serum NT-proBNP level ≥1000 ng/nl, serum Lp-PLA2 level ≥210 ng/ml and the history of heart failure were important risk factors for MACE in patients with acute myocardial infarction (P<0.05). Conclusion: The GRACE score and the abnormal levels of serum NT-proBNP and Lp-PLA2 in patients with MACE after acute myocardial infarction have increased abnormalities, and the GRACE scores and serum NT-proBNP, Lp-PLA2 levels, and the history of heart failure are the important risk factors in patients with MACE. Clinical indicators can be used to predict the risk of MACE in patients with acute myocardial infarction after PCI, and to do the corresponding prevention and control work.
王素玲, 贾永平, 何丽娇. GRACE评分联合血清Lp-PLA2 NT-proBNP水平监测在急性心肌梗死患者PCI术后MACE事件预测中的应用[J]. 河北医学, 2019, 25(5): 737-741.
WANG Suling, JIA Yongping, et al. Application of GRACE Score Combined with Serum Lp-PLA2 and NT-proBNP Levels in Predicting MACE Events after PCI in Patients with AMI. HeBei Med, 2019, 25(5): 737-741.
[1] Luo JG,Yang M,Han L,et al.Validity of the global registry of acute coronary events risk score in prediction of acute myocardial infarction mortality in hospitalised chinese patients aged 80 and over[J].Australas Ageing,2013,33(4):1~5. [2] 宋温婷,李秀,王丹丹,等.血浆脂蛋白相关磷脂酶A2对急性心肌梗死患者住院预后的影响[J].天津医科大学学报,2016,22(2):107~110. [3] Setianto B Y,Hartopo A B,Sukmasari I,et al.On-admission high endothelin-1 level independently predicts in-hospital adverse cardiac events following ST-elevation acute myocardial infarction[J].Int Cardiol,2016,220(1):72~76. [4] 朱汉华,阳维德,郑萍,等.血清妊娠相关蛋白-A与全球急性冠状动脉事件注册评分对急性心肌梗死患者主要不良心血管事件的预测价值[J].中国介入心脏病学杂志,2017,25(4):192~196. [5] Boubaker H,Beltaief K,Grissa M H,et al.Inaccuracy of thrombolysis in myocardial infarction and global registry in acute coronary events scores in predicting outcome in ED patients with potential ischemic chest pain[J].Am Emerg Med,2015,33(9):1209~1212. [6] 项丽,赵良平,朱心怡,等.室壁运动积分与GRACE评分对急性心肌梗死患者的预后价值[J].临床心血管病杂志,2015,31(12):1287~1290. [7] 张莉,许向东,陈霞,等.NT-proBNP、Tei指数联合GRACE评分预测急诊PCI患者短期预后的价值[J].海南医学,2015,26(11):1569~1572. [8] 吴雨径,刘惠亮,李屹,等.血清NT-proBNP与hs-CRP在预测急性ST段抬高性心肌梗死主要心脏不良事件的价值[J].现代生物医学进展,2016,16(17):3317~3321. [9] Wu X,Zhang Y,Wu Z,et al.Plasma lipoprotein-associated phospholipase A2 level is an independent predictor of high thrombus burden in patients with acute ST-segment elevation myocardial infarction[J].Int Heart,2016,57(6):689~696.