Chen Lei, Chen Wensu, Shao Yameng, Zhang Min, Li Zhi, Wang Zhirong, Lu Yuan
Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
Cardiology. 2022;147(4):381-388. doi: 10.1159/000524765. Epub 2022 May 17.
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.
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.
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.
sST2 is an independent predictor of new-onset AF in patients with AMI and can improve the accuracy of the AF risk model.
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。
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。
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。
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。