Prognostic value of hs-CR,NT-pro-BNP combined with GRACE score for short-term MACEs after PCI in STEMI patients

WU Jiao

摘要：Background ST-elevated myocardial infarction(STEMI)is a common type of acute myocardial infarction with high morbidity,disability and mortality,which seriously threatens the life and health of patients.Percutane-ous coronary intervention(PCI)is the preferred treatment for STEMI,which can quickly open blocked coronary arteries and restore myocardial blood perfusion,thus significantly improving the clinical symptoms and prognosis of patients.However,in clinical practice,STEMI patients still face a series of adverse events after PCI,major ad-verse cardiovascular events(MACEs)are predominant.Therefore,in order to accurately evaluate the short-term MACE after PCI in STEMI patients,it is particularly important to explore more sensitive and specific predictors.Methods Clinical data of 150 STEMI patients admitted to our hospital from June 2021 to May 2024 were retro-spectively analyzed,and they were divided into MACEs group(n=42)and non-MACEs group(n=108)according to whether they developed MACEs within 6 months after PCI.The predictive values of highly sensitive C-reac-tive protein(hs-CRP),N-terminal pro-B-type natriuretic peptide(NT-pro-BNP),the Global Registry of Acute Cor-onary Events(GRACE)score and synthetic analysis for short-term MACEs after PCI in STEMI patients were re-spectively analyzed.Either GRACE score＞140,hs-CRP level＞3 mg/mL or NT-pro-BNP level＞1000 pg/mL was considered positive.Synthetic analysis was defined as positive when at least two of the above indicators were pos-itive.Multivariable logistic regression and receiver operation characteristic(ROC)analysis were applied to ana-lyze prognostic values of hs-CR,NT-pro-BNP,GRACE score and synthetic analysis respectively for short-term MACEs after PCI in STEMI patients.Results The level of hs-CRP,NT-pro-BNP and GRACE score in MACEs group were higher than non-MACEs group(P＜0.05).Logistic regression analysis showed that hs-CRP,NT-pro-BNP and GRACE score were all independent risk factors for short-term MACEs after PCI in STEMI patients.Synthetic analysis of hs-CRP,NT-pro-BNP and GRACE score showed the best predictive capacity for the occur-rence of short-term MACEs than any single indicator with the highest area under curve(AUC)of 0.882,sensitivi-ty of 97.62％and specificity of 95.33％.Conclusions Synthetic analysis of hs-CRP,NT-pro-BNP and GRACE score showed the best predictive capacity for the occurrence of short-term MACEs in STEMI patients after PCI.[SS Chin J Cardiol 2024;25(4):232-237]