AIM To investigate the changes in serum levels of C-X3-C chemokine ligand 1 (CX3CL1), intelectin 1 (ITLN-1), and soluble microfibrillar associated protein 4 (sMFAP4) in elderly patients with acute myocardial infarction (AMI) and their predictive value for restenosis after percutaneous coronary intervention (PCI).
METHODS From October 2020 to October 2022, 189 elderly AMI patients who underwent PCI treatment in our hospital were regarded as observation subjects. Patients were followed up for 12 months after surgery and separated into a non restenosis group of 129 cases and a restenosis group of 60 cases based on whether restenosis occurred, enzyme linked immunosorbent assay (ELISA) was applied to detect serum levels of CX3CL1, ITLN-1, and sMFAP4, multivariate Logistic regression was applied to analyze the influencing factors of restenosis after PCI in elderly AMI patients, ROC curve was applied to analyze the predictive value of serum CX3CL1, ITLN-1, and sMFAP4 for restenosis after PCI in elderly AMI patients.
RESULTS Compared with the non restenosis group, the restenosis group had a higher proportion of hypertensive patients (P<0.05), lower levels of TG (P<0.05), higher levels of CX3CL1 (P<0.01), lower levels of ITLN-1 (P<0.05), and higher levels of sMFAP4 (P<0.01). There was no significant difference between the two groups in terms of age, gender, BMI, diabetes, alcohol consumption, number of stents, stent diameter, infarct site, lesion site, HDL-C, TC and serum creatinine. Hypertension (P<0.05), CX3CL1 (P<0.01), and sMFAP4 (P<0.05) are independent risk factors for restenosis in elderly AMI patients after PCI, while ITLN-1 is a protective factor (P<0.01). The AUC of serum CX3CL1, ITLN-1, and sMFAP4 alone or in combination for predicting restenosis after PCI were 0.810 (95% CI: 0.746～0.863), 0.828 (95% CI: 0.766～0.879), 0.782 (95% CI: 0.716～0.838), 0.923 (95% CI: 0.875～0.957), with sensitivities of 66.67%, 85.00%, 85.00%, and 86.67%, and specificity of 89.15%, 72.09%, 62.02%, and 88.37%, respectively, The predictive performance of the combination of the three is better than that of individual prediction (Z=3.680, 3.601, 4.410; all P<0.01).
CONCLUSION The serum levels of CX3CL1 and sMFAP4 in elderly AMI patients increase, while the level of ITLN-1 decreases. These three factors have certain predictive value for the occurrence of restenosis after PCI, and may serve as serum markers for predicting restenosis in elderly AMI patients after PCI.
DownLoad: