Abstract
Objective:To explore hsCRP and ET-1 expressions in patients with no-reflow phenomenon after percutaneous coronary intervention (PCI).Methods:A total of 136 patients with single coronary artery disease receiving PCI were divided into a reflow group and a no-reflow group to compare the level use of ET-1 alone with combined level of ET-1 and hs-CRP in PCI regarding sensitivity, specificity, positive and negative predictive values and accuracy for postoperative no-reflow. The study was conducted between 2014-2016 at our hospital.Results:Postoperative levels of ET-1 and hs-CRP in no-reflow group were significantly higher than those of reflow group (P<0.05). ET-1 level of reflow group peaked three hours after PCI and then declined. Serum level of hs-CRP decreased most obviously within three hours after PCI in reflow group and three hours - three days after PCI in no-reflow group. Left ventricular end-diastolic diameters of both groups after PCI were apparently lower than those before PCI, without significant inter-group difference (P>0.05). Left ventricular end-systolic diameters and left ventricular ejection fractions of both groups evidently increased after PCI, without significant inter-group differences either (P>0.05). Corrected TIMI frame count (CTFC) and wall motion score index of reflow group after PCI were significantly lower than those of no-reflow group (P<0.05). ET-1 level was positively correlated with CTFC (P<0.05). Multivariate linear regression showed hs-CRP was negatively correlated with the serum level (P<0.05) (r=-0.34).Conclusion:hsCRP and ET-1 levels significantly increased in patients with no-reflow phenomenon.
Highlights
Acute myocardial infarction can be classified into acute ST-segment elevation myocardial infarction (STEMI) and acute nonST-segment elevation myocardial infarction.[1,2]
No-reflow phenomenon means that part of infarctrelated artery (IRA) has no forward blood flow after percutaneous coronary intervention (PCI) in the absence of dissection, thrombosis, spasm or distal embolization.[4]
The multiple linear regression analysis was made with ET-1 level as the dependent variable, gender, age, MAP, CTF and WMSI as independent variables, and the results showed that High-sensitivity C-reactive protein (hs-CRP) might be a factor influencing the serum level of STEMI patients (P
Summary
Acute myocardial infarction can be classified into acute ST-segment elevation myocardial infarction (STEMI) and acute nonST-segment elevation myocardial infarction.[1,2] For patients with STEMI, early rapid emergency thrombolytic therapy and/or percutaneous coronary intervention (PCI) can significantly reduce mortality and improve prognosis by clearing infarcted coronary arteries.[3]. The pathophysiological mechanism of no-reflow remains unclear hitherto, but it has been attributed to severe local vascular spasm, obstruction, ischemia of corresponding tissues and organs (generally for 40 to 60 minutes), and release of many inflammatory factors On this basis, no-reflow phenomenon occurs when the ischemic region cannot immediately be perfused with sufficient blood after recanalization for blood flow recovery.[5]. High-sensitivity C-reactive protein (hs-CRP) has an extremely low content in the peripheral blood under normal conditions, but upon inflammation, such level can, as a stress reaction, markedly increase within a short time It is well-documented that hs-CRP strongly indicate myocardial infarction and other inflammatory diseases.[9] CRP is often synthesized by liver cells due to stimulation of interleukin-6 and other inflammatory molecules.[10] In this study, we combined hs-CRP with ET-1 to detect their dynamic changes before and after PCI and the correlation, aiming to provide a scientific basis for the no-reflow phenomenon after PCI
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