The relationship between serum Syndecan-4，TIMP-1 and the number of coronary artery lesions and echocardio-
graphic parameters in STEMI patients Yang Xiaoyan* ，Tang Yujie，Liang Ying，Tang Nianzhong，Zhang Min． * De-
partment of Ultrasound，The First Affiliated Hospital of Naval Medical University，Shanghai 200433，China
Corresponding author: Zhang Min，E-mail: 1499540845@ qq． com
【Abstract】 Objective To analyze the relationship between multi-ligand proteoglycan-4 ( Syndecan-4) ，matrix metal-
loproteinase-1 ( TIMP-1) and the number of coronary artery lesions and echocardiographic parameters in patients with ST-seg-
ment elevation myocardial infarction ( STEMI) ． Methods Sixty-seven patients with STEMI diagnosed and treated by the De-
partment of Cardiology of the First Affiliated Hospital of the Naval Military Medical University from January 2021 to December
2021 were selected as the STEMI group，72 patients with chronic angina pectoris diagnosed at the same time were selected as
·142·疑难病杂志 2023 年 3 月第 22 卷第 3 期 Chin J Diffic and Compl Cas，March 2023，Vol． 22，No． 3

the chronic angina pectoris group，and 50 patients with normal coronary angiography results at the same time were selected as
the control group． According to the Gensini score of coronary angiography，STEMI patients were divided into 25 patients in
subgroup A ( 0-20 points，1 vessel lesion) ，23 patients in subgroup B ( 21-40 points，2 vessel lesions) and 19 patients in
subgroup C ( more than 40 points，3 vessel lesions and more) ． Compare the levels of serum Syndecan-4 and TIMP-1，the pa-
rameters of echocardiography ( left ventricular ejection fraction ( LVEF) ，left ventricular end-diastolic diameter ( LVEDD) ，
left ventricular end-systolic diameter ( LVESD) ，left ventricular end-diastolic volume ( LVEDV) ，left ventricular end-systolic
volume ( LVESV) ，early diastolic mitral flow velocity / late diastolic mitral flow velocity ( E / A) ) Myocardial ischemia index
［cardiac troponin I ( cTnI) ，creatine kinase isoenzyme MB ( CK-MB) ］，heart failure index ［N-terminal B-type natriuretic
peptide ( NT-proBNP) ］，Pearson method was used to analyze the relationship between serum Syndecan-4 and TIMP-1 levels
and Gensini score and echocardiographic parameters in patients with STEMI，and the value of serum Syndecan-4 and TIMP-1
in predicting STEMI was analyzed by subject working characteristic curve ( ＲOC) ． Ｒesults Compared with the serum levels
of Syndecan-4，TIMP-1 and LVESD，STEMI group ＞ chronic angina pectoris group ＞ control group ( F = 253． 293，
67 612． 917，20． 563，P ＜ 0． 001) ． LVEF level: STEMI group ＜ chronic angina pectoris group ＜ control group ( F = 28． 194，P
＜ 0． 001) ，there was no significant difference in LVEDD，LVEDV，LVESV and E / A among the three groups ( P ＞ 0． 05) ．
The levels of cTnI，CK-MB and NT-proBNP in STEMI group were higher than those in chronic angina pectoris group and con-
trol group ( F = 1809． 343，1352． 872，2289． 851，P ＜ 0． 001) ． The levels of cTnI and NT-proBNP in chronic angina pectoris
group were higher than those in control group ( P ＜ 0． 05) ． Gensini score comparison: subgroup C ＞ subgroup B ＞ subgroup A
( F = 951． 801，P ＜ 0． 001) ． The serum levels of Syndecan-4，TIMP-1 and LVESD in subgroups A，B and C increased in turn
( F / P = 4． 405 /0． 016，2965． 986 / ＜ 0． 001，3． 520 /0． 035 ) ，while the LVEF level decreased in turn ( F / P = 5． 385 /0．
007) ． There was no statistically significant difference between LVEDD，LVEDV，LVESV and E / A in subgroups 3 ( P ＞ 0．
05) ． The serum levels of Syndecan-4 and TIMP-1 in STEMI patients were positively correlated with Gensini score and
LVESD ( Gensini score: r / P = 0． 418 / ＜ 0． 001，0． 375 / ＜ 0． 001; LVESD: r / P = 0． 391 / ＜ 0． 001，0． 278 /0． 004 ) ，and
negatively correlated with LVEF ( r / P = － 0． 492 / ＜ 0． 001， － 0． 436 / ＜ 0． 001) ，but not with LVEDD，LVEDV，LVESV
and E / A ( P ＞ 0． 05) ． The area under the curve ( AUC) of serum Syndecan-4，TIMP-1 and their combination to predict
STEMI were 0． 849，0． 917 and 0． 927，respectively． The combined predictive value of the two indexes was higher than that
of the single index ( Z = 18． 623，11． 736，P ＜ 0． 001 ) ． Conclusion The serum levels of Syndecan-4 and TIMP-1 are
highly correlated with the number of coronary artery lesions and echocardiographic parameters，and can be used as important
biomarkers for the detection of coronary artery lesion degree and myocardial injury in STEMI patients．
【Key words】 ST-segment elevation myocardial infarction; Syndecan-4; Tissue inhibitor of metalloproteinase-1; Coro-
nary artery lesion vessel number; Echocardiographic parameters; Correlation