血清TFAM、SSC5D水平与急性心肌梗死患者心功能分级的关系及对PCI术后发生心肌低灌注的预测价值OA

Objective To explore the relationship between serum mitochondrial transcription factor A(TFAM)and soluble scavenger receptor protein with cysteine-rich domain(SSC5D)levels and the cardiac function classification in patients with acute myocardial infarction(AMI),and their predictive value for myo-cardial hypoperfusion after percutaneous coronary intervention(PCI).Methods A total of 151 AMI patients treated in the hospital from July 2021 to July 2024 were selected as the myocardial infarction group,and 151 healthy subjects who underwent physical examinations in the hospital during the same period were selected as the healthy control group.The preoperative cardiac function status of the patients was evaluated according to the Killip classification method,AMI patients were divided into the normal perfusion group and the hypoper-fusion group according to the TIMI flow grading system.The serum TFAM and SSC5D levels in all subjects were detected.The baseline data of AMI patients were collected.Spearman correlation analysis was used to an-alyze the correlation between the serum levels of TFAM and SSC5D and the Killip classification in AMI pa-tients.Multivariate Logistic regression analysis was used to analyze the influencing factors for myocardial hy-poperfusion after PCI in AMI patients.The receiver operating characteristic(ROC)curve was drawn to evalu-ate the predictive value of serum TFAM and SSC5D for myocardial hypoperfusion after PCI in AMI patients.Results The serum TFAM level in the myocardial infarction group was lower than that in the healthy control group,and the serum SSC5D level was higher than that in the healthy control group,with statistically signifi-cant differences(P<0.05).The evaluation results of Killip cardiac function classification showed that there were 47 cases of Killip grade Ⅰ,53 cases of Killip grade Ⅱ,31 cases of Killip grade Ⅲ,and 20 cases of Killip grade Ⅳ.The serum TFAM level was in the order of Killip grade Ⅳ<Killip grade Ⅲ<Killip grade Ⅱ<Killip grade Ⅰ,and the differences between each two grades were statistically significant(P<0.05).The serum SSC5D level was in the order of Killip grade Ⅳ>Killip grade Ⅲ>Killip grade Ⅱ>Killip grade Ⅰ,and the differences between each two grades were statistically significant(P<0.05).The results of Spearman correla-tion analysis showed that the serum TFAM level in AMI patients was negatively correlated with the Killip classification(P<0.05),and the serum SSC5D level was positively correlated with the Killip classification(P<0.05).The TIMI examination results showed that there were 106 cases in the normal perfusion group and 45 cases in the hypoperfusion group.The proportions of co-existing hypertension and Killip grade Ⅲ-Ⅳand the serum SSC5D level in the hypoperfusion group were higher than those in the normal perfusion group,while the left ventricular ejection fraction and the serum TFAM level were lower than those in the normal per-fusion group,with statistically significant differences(P<0.05).The results of multivariate Logistic regres-sion analysis showed that co-existing hypertension,Killip grade Ⅲ-Ⅳ,and increased serum SSC5D level were all risk factors for myocardial hypoperfusion after PCI in AMI patients(P<0.05),while increased LVEF and serum TFAM level were protective factors for myocardial hypoperfusion after PCI in AMI patients(P<0.05).The results of ROC curve analysis showed that the areas under the curve(AUC)of serum TFAM and SSC5D alone and in combination in predicting myocardial hypoperfusion after PCI in AMI patients were 0.849,0.833 and 0.933,respectively,and the AUC of their combined prediction was significantly higher than that of serum TFAM(Z=2.226,P<0.05)and SSC5D(Z=2.378,P<0.05)alone.Conclusion In AMI pa-tients,the serum TFAM level is decreased and the serum SSC5D level is increased.Both levels of serum TFAM and SSC5D are related to the Killip classification,and their combined detection has a high predictive value for myocardial hypoperfusion after PCI in AMI patients.