心电图联合血清IL-33、ANGPTL3对急性心肌梗死患者PCI术后主要不良心血管事件发生的预测价值OA

Objective To explore the predictive value of electrocardiogram(ECG)combined with serum interleukin-33(IL-33)and angiopoietin-like protein 3(ANGPTL3)for the occurrence of major adverse cardiovascular events(MACE)in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods A total of 110 AMI patients treated in the Department of Cardiology of the First Affiliated Hospital of Xi'an Jiaotong University from Au-gust 2021 to December 2024 were selected as the study subjects.Based on the 6-month follow-up results after PCI,they were divided into a MACE group(n=32)and a non-MACE group(n=78).Serum levels of IL-33 and ANGPTL3 were measured using ELISA.Logistic regression analysis was used to analyze the factors influencing the occurrence of MACE.Receiver oper-ating characteristic(ROC)curve analysis was employed to evaluate the predictive value of ECG combined with serum IL-33 and ANGPTL3 for MACE in AMI patients after PCI.Results Compared with the non-MACE group,the MACE group had older age,longer time from onset to PCI treatment,higher proportion of patients with ≥ 3 diseased vessels,higher proportion of left main coronary artery as the culprit vessel,and lower proportion of pre-onset antiplatelet drug use(x2/t/P=1.991/0.049,4.156/＜0.001,7.678/0.006,4.250/0.039,4.198/0.040,respectively).The incidence of ECG T-wave inversion and serum levels of IL-33 and ANGPTL3 in the MACE group were significantly higher than those in the non-MACE group(x2/t/P=16.206/0.013,6.209/＜0.001,6.021/＜0.001,respectively).Older age,longer time from onset to PCI treatment,higher proportion of ≥3 diseased vessels,lower proportion of pre-onset antiplatelet drug use,presence of T-wave inversion,and elevated serum levels of IL-33 and ANGPTL3 were identified as risk factors for MACE in AMI patients after PCI[odds ratio(OR)(95％confi-dence interval,95％CI)=1.233(0.755-1.981),1.642(0.886-3.044),1.549(0.852-2.816),1.573(0.981-2.523),0.420(0.121-1.455),1.994(1.067-3.726),respectively].The area under the curve(AUC)of ECG combined with serum IL-33 and ANGPTL3 for predicting MACE in AMI patients after PCI was 0.986,which was superior to the predictive value of each sin-gle indicator alone(AUC of ECG=0.865,Z value for ECG vs.the three-index combination=5.075,P＜0.001;AUC of IL-33=0.837,Z value for IL-33 vs.the three-index combination=3.424,P=0.001;AUC of ANGPTL3=0.816,Z value for ANGPTL3 vs.the three-index combination=3.640,P＜0.001).The accuracy rate of T-wave inversion in predicting MACE in AMI patients 6 months after PCI was 68.18％,that of elevated serum IL-33 level was 80.00％,that of elevated serum ANGPTL3 level was 82.73％,and that of the combination of the three indicators was 91.82％,significantly higher than the single prediction of the three indicators(x2/P=19.205/＜0.001,6.346/0.012,4.092/0.043).Conclusion ECG T-wave inversion and elevated serum levels of IL-33 and ANGPTL3 are independent risk factors for MACE in AMI patients after PCI,and the combination of these three indicators has higher predictive value for MACE occurrence.