关键词:

冠心病, 老年, 经皮冠状动脉介入治疗, 主要不良心血管事件, 生长停滞特异性基因产物6, 中性粒细胞胞外诱捕网

Abstract:

Objective　To explore the influences of serum levels of growth arrest-specific gene 6 (Gas6) and neutrophil extracellular traps (NETs) on the prognosis of elderly patients with coronary heart disease after interventional therapy. Methods　This study was a retrospective study. The clinical data of 242 elderly patients with coronary heart disease who underwent percutaneous coronary intervention (PCI) at Yan'an University Xianyang Hospital from April 2022 to September 2023 were collected. Based on whether the major adverse cardiovascular events (MACE) occurred during the follow-up period, the patients were divided into a MACE group [40 cases, including 28 males and 12 females, with an age of (73.28±6.59) years old] and a non-MACE group [202 cases, including 130 males and 72 females, with an age of (72.10±5.47) years old]. Univariate analysis (χ² test and t test) and multivariate logistic regression analysis were used to evaluate the independent factors for the occurrence of MACE after PCI. The receiver operating characteristic curve (ROC) analysis was used to determine the predictive power of Gas6 and NETs for MACE. The Kaplan-Meier survival curve was used to assess the predictive value of Gas6 and NETs levels for MACE incidence. Results　The rate of number of stents ≥2 in the MACE group was higher than that in the non-MACE group [62.50% (25/40) vs. 37.62% (76/202)], with a statistically significant difference (χ²=8.497, P<0.05). The Global Registry of Acute Coronary Events (GRACE) score, apolipoprotein B/apolipoprotein A (ApoB/ApoA), low-density lipoprotein cholesterol (LDL-C), lipoprotein(a) [Lp(a)], Gas6, and NETs levels in the MACE group were all higher than those in the non-MACE group [(120.28±15.40) points vs. (85.58±12.27) points, (0.81±0.22) vs. (0.73±0.17), (2.53±0.38) mmol/L vs. (2.38±0.31) mmol/L, (443.30±168.83) mg/L vs. (297.40±124.59) mg/L, (24.60±5.76) μg/L vs. (16.69±4.90) μg/L, (30.47±9.08) μg/L vs. (20.28±6.10) μg/L], with statistically significant differences (t=13.432, 2.175, 2.688, 5.193, 9.051, and 6.800, all P<0.05). Multivariate logistic regression analysis revealed that the GRACE score and serum Gas6 and NETs levels were independent risk factors for the occurrence of MACE after PCI (all P<0.05). ROC analysis showed that the sensitivities of Gas6 and NETs in predicting the occurrence of MACE in elderly patients with coronary heart disease after interventional therapy were 80.0% and 67.5%, respectively, the specificities were 80.2% and 85.6%, respectively, and the areas under the curve (AUCs) were 0.862 and 0.817, respectively; when Gas6 and NETs were combined for prediction, the sensitivity and specificity were 85.0% and 86.6%, respectively, and the AUC value reached 0.937. The probability of MACE after PCI in patients with high level of Gas6 or NETs was higher than that in patients with low level of Gas6 or NETs (both P<0.05). Conclusion　Elevated serum levels of Gas6 and NETs are closely associated with an increased incidence of MACE in elderly patients with coronary heart disease after PCI, and Gas6 and NETs can serve as potential biomarkers for predicting poor prognosis in these patients following interventional therapy.

Key words:

Coronary heart disease, Elderly, Percutaneous coronary intervention, Major adverse cardiovascular events, Growth arrest-specific gene 6, Neutrophil extracellular traps