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可溶性肿瘤抑制因子2与急性心肌梗死新发心房颤动的关联

Association of Soluble Suppression of Tumorigenicity 2 with New-Onset Atrial Fibrillation in Acute Myocardial Infarction.

作者信息

Chen Lei, Chen Wensu, Shao Yameng, Zhang Min, Li Zhi, Wang Zhirong, Lu Yuan

机构信息

Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.

出版信息

Cardiology. 2022;147(4):381-388. doi: 10.1159/000524765. Epub 2022 May 17.

Abstract

BACKGROUND

The combination of acute myocardial infarction (AMI) and atrial fibrillation (AF) is still a thorny problem in the clinic. At present, there are few reports on the role of soluble suppression of tumorigenicity 2 (sST2) in AF after AMI. This study was to explore the predictive value of sST2 in patients with AMI for new-onset AF.

METHODS

This is a single-center retrospective clinical observation study. We continuously included AMI patients from September 2019 to November 2021. The concentration of sST2 in blood samples was determined. During admission, a suspicious heart rhythm was recorded by electrocardiogram (ECG) monitoring, and new-onset AF was confirmed by immediate body surface ECG.

RESULTS

After multiple factors were included, age, right coronary artery, high-sensitivity C-reactive protein, left ventricular ejection fraction, and sST2 were still risk factors for new-onset AF. The area under curve value of age and sST2 was more than 0.7, which showed good diagnostic value. For reevaluation, the sST2 was added to the clinical new-onset AF prediction model. It was found that the integrated discrimination improvement and net reclassification index in the model were improved significantly.

CONCLUSION

sST2 is an independent predictor of new-onset AF in patients with AMI and can improve the accuracy of the AF risk model.

摘要

背景

急性心肌梗死(AMI)合并心房颤动(AF)仍是临床上棘手的问题。目前,关于可溶性肿瘤抑制因子2(sST2)在AMI后AF中作用的报道较少。本研究旨在探讨sST2对AMI患者新发AF的预测价值。

方法

这是一项单中心回顾性临床观察研究。我们连续纳入了2019年9月至2021年11月的AMI患者。测定血样中sST2的浓度。入院期间,通过心电图(ECG)监测记录可疑心律,并通过即刻体表心电图确诊新发AF。

结果

纳入多因素后,年龄、右冠状动脉、高敏C反应蛋白、左心室射血分数和sST2仍是新发AF的危险因素。年龄和sST2的曲线下面积值均大于0.7,显示出良好的诊断价值。为进行重新评估,将sST2纳入临床新发AF预测模型。发现模型中的综合判别改善和净重新分类指数均有显著提高。

结论

sST2是AMI患者新发AF的独立预测因子,可提高AF风险模型的准确性。

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