Xu Lou-Yuan, Xie Ling, Wang Jing, Chen Hai-Xiao, Cai Hong-Li, Tian Li-Jun, Zhang Qing
Department of Cardiology, Second Affiliated Hospital of Nantong University, Nantong, China.
Department of General Medicine, Second Affiliated Hospital of Nantong University, Nantong, China.
Front Cardiovasc Med. 2022 Jul 22;9:936983. doi: 10.3389/fcvm.2022.936983. eCollection 2022.
Acute myocardial infarction (AMI) is a critical cardiovascular disease (CVD). Laminin (LN) is involved in the process of myocardial fibrosis and ventricular remodeling observed in AMI; however, there are currently no studies on the correlation between LN and AMI prognosis.
To explore the predictive value of serum LN levels for major adverse cardiovascular events (MACE) in patients, 6 months after an acute myocardial infarction.
A total of 202 AMI patients who were hospitalized in the Department of Cardiology of the Second Affiliated Hospital of Nantong University between December 2019 and December 2020 were included. The observation endpoint was the occurrence of MACE. Univariate and multivariate logistic analyses were used to evaluate the relationships between the variables and endpoint. The predictive value of LN for MACE in AMI patients was assessed using receiver operating characteristic (ROC) analysis.
A total of 47 patients developed MACE. Univariate logistic analysis showed that smoking, emergency percutaneous coronary intervention (EPCI), age, cardiac troponin I (c-TNI) levels, N-terminal prohormone brain natriuretic peptide (NT-proBNP) levels, and LN levels were associated with the occurrence of MACE ( < 0.05). Multivariate logistic analysis showed that LN was an independent predictor of MACE (odds ratio [OR] = 1.021, 95%CI: 1.014-1.032, < 0.001). According to the ROC curve, LN can be used as an effective predictor of MACE (AUC = 0.856, 95%CI: 0.794-0.918, < 0.001). According to the cutoff value, LN>58.80 ng/ml (sensitivity = 83.00%, specificity = 76.80%) or LN>74.15 ng/ml (sensitivity = 76.6%, specificity = 83.2%) indicate a poor prognosis for AMI. Different cut-off values are selected according to the need for higher sensitivity or specificity in clinical applications.
LN may be a predictor of MACE following AMI in patients and could be utilized as a novel substitute marker for the prevention and treatment of AMI.
急性心肌梗死（AMI）是一种严重的心血管疾病（CVD）。层粘连蛋白（LN）参与了AMI中观察到的心肌纤维化和心室重构过程；然而，目前尚无关于LN与AMI预后相关性的研究。
探讨急性心肌梗死后6个月患者血清LN水平对主要不良心血管事件（MACE）的预测价值。
纳入2019年12月至2020年12月在南通大学第二附属医院心内科住院的202例AMI患者。观察终点为MACE的发生。采用单因素和多因素logistic分析评估变量与终点之间的关系。采用受试者工作特征（ROC）分析评估LN对AMI患者MACE的预测价值。
共有47例患者发生MACE。单因素logistic分析显示，吸烟、急诊经皮冠状动脉介入治疗（EPCI）、年龄、心肌肌钙蛋白I（c-TNI）水平、N末端脑钠肽前体（NT-proBNP）水平和LN水平与MACE的发生相关（<0.05）。多因素logistic分析显示，LN是MACE的独立预测因子（比值比[OR]=1.021，95%CI：1.014-1.032，<0.001）。根据ROC曲线，LN可作为MACE的有效预测因子（AUC=0.856，95%CI：0.794-0.918，<0.001）。根据截断值，LN>58.80 ng/ml（敏感性=83.00%，特异性=76.80%）或LN>74.15 ng/ml（敏感性=76.6%，特异性=83.2%）表明AMI预后不良。在临床应用中，可根据对更高敏感性或特异性的需求选择不同的截断值。
LN可能是AMI患者发生MACE的预测因子，可作为预防和治疗AMI的新型替代标志物。
