载脂蛋白A1/载脂蛋白B比值对急性心肌梗死患者PCI后无复流的预测价值OA

Objective To investigate the predictive value of the apolipoprotein(Apo)A1/ApoB for no-reflow after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).Methods A total of 106 AMI patients admitted to the Affiliated People's Hospital of Ningbo University from January 2018 to March 2022 were retrospectively selected for the study.The thrombolysis in myocardial infarction(TIMI)flow grade was used to assess coronary reperfusion,with TIMI grade≤2 as the no-reflow group(29 cases)and TIMI grade>2 as the reflow group(77 cases).Serum levels of ApoA1 and ApoB were measured using enzyme-linked immunosorbent assay(ELISA),and the ApoA1/ApoB ratio was calculated.Pearson correlation analysis was performed to evaluate the relationship between ApoA1 and ApoB in AMI patients.Logistic regression analysis was used to identify factors influencing no-reflow after PCI treatment in AMI patients.The predictive value of ApoA1,ApoB,and their ratio for no-reflow after PCI treatment in AMI patients was assessed using receiver operating characteristic(ROC)curve analysis.Results Compared with the reflow group,the no-reflow group had higher levels of cardiac troponin I(cTnI)(t=7.450,P<0.05),total cholesterol(t=5.226,P<0.05),and ApoB(t=8.987,P<0.05),and lower levels of ApoA1(t=5.960,P<0.05)and ApoA1/ApoB ratio(t=8.959,P<0.05).ApoA1 and ApoB levels were negatively correlated(r=-0.590,P<0.05).High levels of cTnI(OR=2.791,95%CI=1.502-5.185,P<0.05)and ApoB(OR=2.175,95%CI=1.051-4.501,P<0.05)were identified as risk factors for no-reflow,while high levels of ApoA1(OR=0.722,95%CI=0.565-0.922,P<0.05)and ApoA1/ApoB ratio(OR=0.566,95%CI=0.459-0.698,P<0.05)were protective factors.The areas under the curve(AUCs)for serum ApoA1,ApoB,ApoA1/ApoB ratio,and their combined prediction of no-reflow in AMI patients after PCI were 0.843,0.887,0.915,and 0.956,respectively.The combined prediction was superior to any individual prediction(Z=2.500,2.301,2.023;P<0.05).Conclusion ApoB,ApoA1 and ApoA1/ApoB ratio are influencing factors for no-reflow in AMI patients after PCI.Serum ApoA1,ApoB,and the ApoA1/ApoB ratio all have predictive value for no-reflow in AMI patients after PCI and their combined prediction possesses a higher value.