Abstract:
Objective To investigate the predictive effect of multiple serological indicators on the occurrence of heart failure (HF) after percutaneous coronary intervention (PCI) in elderly patients with acute myocardial infarction (AMI).
Methods A retrospective study was conducted on 276 elderly AMI patients. Based on whether HF occurred within 6 months, they were divided into HF group (n=65) and non-HF group (n=211). Multivariate Logistic regression was used to screen the influencing factors of AMI complicated with HF. The receiver operating characteristic (ROC) curve was applied to evaluate the efficacy of serological indicators in predicting HF.
Results Age, uric acid, fibrinogen, high-sensitivity C-reactive protein (hs-CRP), systemic immune-inflammation index (SII) and level of interleukin-6 (IL-6) in the HF group were significantly higher than those in the non-HF group, while the left ventricular ejection fraction and the proportion of TIMI grade 3 blood flow in the HF group were significantly lower (P < 0.05). Multivariate Logistic regression analysis showed that age (OR=1.401, 95%CI, 1.103 to 1.937), hs-CRP (OR=1.428, 95%CI, 1.108 to 1.839), SII (OR=1.645, 95%CI, 1.262 to 2.145), uric acid (OR=1.376, 95%CI, 1.123 to 1.685) and TIMI grade 3 blood flow (OR=0.502, 95%CI, 0.335 to 0.752) were independent influencing factors for HF after PCI in AMI patients. The ROC curve demonstrated that the area under the curve (AUC) of hs-CRP, SII and uric acid for predicting HF after PCI in AMI patients were 0.694 (95%CI, 0.619 to 0.768), 0.854 (95%CI, 0.796 to 0.912) and 0.716 (95%CI, 0.646 to 0.786), respectively, with sensitivities of 75.38%, 81.54% and 66.15%, and specificities of 57.32%, 74.88% and 73.93%.
Conclusion SII has the highest predictive value for HF after PCI in elderly AMI patients, which is helpful for assisting clinical management of high-risk HF populations.