Feng Yi-Fan, Su Ming-Yu, Xu Hui-Xian, Zhang Shu-Zhan, Ma Yan-Feng, Chen Hong-Ping
Department of Laboratory Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China.
Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China.
BMC Cardiovasc Disord. 2024 Dec 20;24(1):722. doi: 10.1186/s12872-024-04406-9.
The activation of the plasmatic coagulation system is a significant contributor to acute myocardial infarction (AMI). This study aimed to investigate the association between the levels of tissue plasminogen activator-inhibitor complex (t-PAIC), thrombin-antithrombin complex (TAT), plasmin-α2 plasmin-inhibitor complex (PIC), and thrombomodulin (TM) with clinical outcomes in patients with AMI.
Blood samples were collected from 368 patients presenting with acute myocardial infarction in the emergency department to assess levels of t-PAIC, TAT, PIC, and TM. Patients were subsequently followed up for a period of 6 months.
t-PAIC levels were significantly elevated in AMI patients who died compared to those who survived (P < 0.0001). Specifically, of the 368 patients, 48 died and had higher t-PAIC levels above the determined cut-off value of 15.3 ng/mL, while 320 survived and had levels below this threshold (P < 0.001). Furthermore, among the survivors, t-PAIC levels were greater in the major adverse cardiovascular events (MACE) group than in the non-MACE group throughout the 6-month follow-up. Linear regression analysis indicated that high levels of t-PAIC were linked to mortality following acute myocardial infarction and raised the likelihood of MACE in survivors. The ROC curve study revealed that t-PAIC has predictive value for mortality following AMI, with an AUC of 0.871 (95% CI: 0.833-0.904), sensitivity of 81.25%, and specificity of 88.75%. Analysis of the ROC curve and Kaplan-Meier survival curve demonstrated that t-PAIC was able to forecast MACE in individuals who had experienced an AMI, with an AUC of 0.671 (95% CI: 0.620-0.719) for 6-month MACE occurrences.
Our findings suggest that increased t-PAIC levels are correlated with mortality in patients with AMI and the incidence of MACE within a six-month period in survivors.
血浆凝血系统的激活是急性心肌梗死（AMI）的一个重要促成因素。本研究旨在探讨组织纤溶酶原激活物-抑制剂复合物（t-PAIC）、凝血酶-抗凝血酶复合物（TAT）、纤溶酶-α2纤溶酶抑制剂复合物（PIC）和血栓调节蛋白（TM）水平与AMI患者临床结局之间的关联。
从急诊科368例急性心肌梗死患者中采集血样，以评估t-PAIC、TAT、PIC和TM水平。随后对患者进行为期6个月的随访。
与存活的AMI患者相比，死亡患者的t-PAIC水平显著升高（P < 0.0001）。具体而言，在368例患者中，48例死亡，其t-PAIC水平高于确定的临界值15.3 ng/mL，而320例存活患者的水平低于该阈值（P < 0.001）。此外，在存活者中，在整个6个月的随访期间，主要不良心血管事件（MACE）组的t-PAIC水平高于非MACE组。线性回归分析表明，高水平的t-PAIC与急性心肌梗死后的死亡率相关，并增加了存活者发生MACE的可能性。ROC曲线研究显示，t-PAIC对AMI后的死亡率具有预测价值，AUC为0.871（95%CI：0.833 - 0.904），敏感性为81.25%，特异性为88.75%。ROC曲线和Kaplan-Meier生存曲线分析表明，t-PAIC能够预测经历过AMI的个体发生MACE的情况，对于6个月内发生MACE的AUC为0.671（95%CI：0.620 - 0.719）。
我们的研究结果表明，t-PAIC水平升高与AMI患者的死亡率以及存活者6个月内MACE的发生率相关。
