摘要
Abstract
Objective To investigate the relationship between serum lipoprotein(a)[Lp(a)],apolipoprotein A(Apo-A),triglyceride glucose(TyG)index,and the severity of coronary artery lesions in patients with ST-segment elevation myocardial infarction(STEMI),and to analyze the predictive value of serum Lp(a),Apo-A,and TyG index for short-term major adverse cardiovascular events(MACE)in STEMI patients.Methods A retrospective study was conducted on 106 STEMI patients who were admitted to Shengli Oilfield Central Hospital from March 2020 to March 2023.Patients were divided into three groups based on the severity of coronary artery lesions:a mild group(32 cases),a moderate group(58 cases),and a severe group(16 cases).According to the occurrence of MACE within 28 days after diagnosis,the patients were classified into a MACE group(10 cases)and a non-MACE group(96 cases).Clinical data of the patients were collected.Levels of Lp(a),Apo-A,and TyG index among the mild,moderate,and severe groups were compared.Pearson correlation analysis was used to investigate the relationship between Lp(a),Apo-A,and TyG index and the severity of coronary artery lesions.Clinical data between the MACE group and the non-MACE group were compared,and a multivariate Cox regression model was used to identify risk factors for short-term MACE in STEMI patients.The predictive value of Lp(a),Apo-A,and TyG index for short-term MACE in STEMI patients was evaluated using ROC curve analysis.Results There were statistically significant differences in serum Lp(a),Apo-A,and TyG index levels among the mild,moderate,and severe groups(F=30.637,8.012,12.629;P＜0.05).Pearson correlation analysis showed that Lp(a),Apo-A,and TyG index were positively correlated with SYNTAX score(r=0.461,0.508,0.513;P＜0.05).Multivariate Cox regression analysis indicated that the serum Lp(a),Apo-A and TyG index were risk factors for the occurrence of short-term MACE in STEMI patients(HR=2.591,1.543,3.185;P＜0.01).ROC curve analysis showed that Lp(a),Apo-A,and TyG index had predictive value for short-term MACE in STEMI patients.The combined prediction of the three indicators had a higher AUC of 0.859 compared to individual indicators(Z=3.097,3.458,2.562;P＜0.05).Conclusion Serum Lp(a),Apo-A,and TyG index are positively correlated with the severity of coronary artery lesions in STEMI patients and can predict the occurrence of short-term MACE.The combined detection of the three has higher predictive value.关键词
ST段抬高型心肌梗死/冠状动脉病变程度/脂蛋白(a)/载脂蛋白-A/甘油三酯-葡萄糖乘积指数Key words
ST-segment elevation myocardial infarction/Severity of coronary artery lesions/Lipoprotein(a)/Apolipoprotein A/Triglyceride glucose index
