Objective To investigate the expression of prostaglandin-endoperoxide synthase 1(PTGS1) and myosin light chain 4(MYL4) in peripheral blood of patients with atrial fibrillation(AF), and their correlation with thromboembolic(TE) risk. Methods A prospective study enrolled 125 AF patients admitted to the Cardiovascular Center of Yan'an University Affiliated Hospital from January 2022 to February 2024(AF group) and 125 age-and sex-matched healthy volunteers(control group) at a 1:1 ratio. AF patients were followed for 1 year and divided into TE and non-TE subgroups according to the occurrence of TE events. Peripheral blood PTGS1 and MYL4 levels were measured by enzyme-linked immunosorbent assay. Spearman correlation analysis was performed to assess the relationship between PTGS1, MYL4 levels and CHA 2DS 2-VASc scores in AF patients. Multivariate logistic regression and receiver operating characteristic(ROC) curve analysis were used to evaluate the association and predictive value of PTGS1 and MYL4 levels for TE risk in AF patients. Results Compared with the control group, AF patients exhibited higher PTGS1 and lower MYL4 levels in peripheral blood(t=13.543,-12.316; both P<0.001). During the 1-year follow-up, the incidence of TE events in AF patients was 30.40%(38/125). Compared with the non-TE subgroup, patients in the TE subgroup were older, had a higher prevalence of diabetes, heart failure, prior IS/TIA, higher CHA 2DS 2-VASc scores, elevated PTGS1, and decreased MYL4 levels(χ 2/t=3.010, 4.848, 7.430, 10.944, 8.009, 5.796,-5.738; P= 0.003, 0.028, 0.006, 0.001, <0.001, <0.001, <0.001). PTGS1 levels were positively correlated with CHA 2DS 2-VASc scores, while MYL4 levels were negatively correlated(r s=0.702,-0.678; both P<0.001). Advanced age, prior IS/TIA, high CHA 2DS 2-VASc score, and elevated PTGS1 were independent risk factors for TE in AF patients, whereas higher MYL4 was an independent protective factor[OR(95%CI)=1.154(1.035-1.286), 3.663(1.578-8.500), 1.857(1.316-2.620), 2.335(1.481-3.681), 0.864(0.801-0.931)]. The area under the curve(AUC) for PTGS1, MYL4, and their combination in predicting TE risk were 0.812, 0.775, and 0.894, respectively, with the combined prediction significantly superior to either marker alone(Z=2.726, 3.367; both P<0.001). Conclusion Elevated peripheral blood PTGS1 and decreased MYL4 levels are associated with increased TE risk in AF patients. The combined assessment of PTGS1 and MYL4 provides higher predictive efficacy for TE events.

Objective To explore the predictive value of electrocardiogram(ECG) combined with serum interleukin-33(IL-33) and angiopoietin-like protein 3(ANGPTL3) for the occurrence of major adverse cardiovascular events(MACE) in patients with acute myocardial infarction(AMI) after percutaneous coronary intervention(PCI). Methods A total of 110 AMI patients treated in the Department of Cardiology of the First Affiliated Hospital of Xi'an Jiaotong University from August 2021 to December 2024 were selected as the study subjects. Based on the 6-month follow-up results after PCI, they were divided into a MACE group(n=32) and a non-MACE group(n=78). Serum levels of IL-33 and ANGPTL3 were measured using ELISA. Logistic regression analysis was used to analyze the factors influencing the occurrence of MACE. Receiver operating characteristic(ROC) curve analysis was employed to evaluate the predictive value of ECG combined with serum IL-33 and ANGPTL3 for MACE in AMI patients after PCI. Results Compared with the non-MACE group, the MACE group had older age, longer time from onset to PCI treatment, higher proportion of patients with ≥3 diseased vessels, higher proportion of left main coronary artery as the culprit vessel, and lower proportion of pre-onset antiplatelet drug use(χ 2/t/P=1.991/0.049, 4.156/<0.001, 7.678/0.006, 4.250/0.039, 4.198/0.040, respectively). The incidence of ECG T-wave inversion and serum levels of IL-33 and ANGPTL3 in the MACE group were significantly higher than those in the non-MACE group(χ 2/t/P=16.206/0.013, 6.209/<0.001, 6.021/<0.001, respectively). Older age, longer time from onset to PCI treatment, higher proportion of ≥3 diseased vessels, lower proportion of pre-onset antiplatelet drug use, presence of T-wave inversion, and elevated serum levels of IL-33 and ANGPTL3 were identified as risk factors for MACE in AMI patients after PCI [odds ratio(OR)(95% confidence interval, 95%CI) = 1.233(0.755-1.981), 1.642(0.886-3.044), 1.549(0.852-2.816), 1.573(0.981-2.523), 0.420(0.121-1.455), 1.994(1.067-3.726), respectively]. The area under the curve(AUC) of ECG combined with serum IL-33 and ANGPTL3 for predicting MACE in AMI patients after PCI was 0.986, which was superior to the predictive value of each single indicator alone(AUC of ECG = 0.865, Z value for ECG vs. the three-index combination=5.075, P<0.001; AUC of IL-33=0.837, Z value for IL-33 vs. the three-index combination=3.424, P=0.001; AUC of ANGPTL3= 0.816, Z value for ANGPTL3 vs. the three-index combination=3.640, P<0.001). The accuracy rate of T-wave inversion in predicting MACE in AMI patients 6 months after PCI was 68.18%, that of elevated serum IL-33 level was 80.00%, that of elevated serum ANGPTL3 level was 82.73%, and that of the combination of the three indicators was 91.82%, significantly higher than the single prediction of the three indicators(χ 2/P=19.205/<0.001, 6.346/0.012, 4.092/0.043). Conclusion ECG T-wave inversion and elevated serum levels of IL-33 and ANGPTL3 are independent risk factors for MACE in AMI patients after PCI, and the combination of these three indicators has higher predictive value for MACE occurrence.

Objective To analyze the predictive value of serum Parkinson's disease protein 7(DJ-1), kallikrein inhibitor(Kallistatin) and tumor protein P53(TP53) for major adverse cardiovascular events(MACE) after percutaneous coronary intervention(PCI) in patients with acute myocardial infarction(AMI). Methods From January 2024 to October 2024, 102 patients with AMI admitted to the Department of Cardiovascular Medicine of Inner Mongolia Baogang Hospital were selected as the AMI group, and 100 healthy volunteers who underwent physical examination in the hospital during the same period were selected as the healthy control group. Serum levels of DJ-1, Kallistatin and TP53 were detected by ELISA. The AMI patients were followed up for 6 months, and the occurrence of recurrent MACE was recorded. Patients with recurrent MACE were assigned to the poor prognosis subgroup, while the rest were classified into the good prognosis subgroup. The Pearson method was used to analyze the correlation between serum DJ-1, Kallistatin and TP53. Logistic regression was performed to identify risk factors for poor prognosis in AMI patients, and ROC curve analysis was used to evaluate the predictive efficacy for poor prognosis. Results The serum levels of DJ-1(t=7.397, P<0.001) and Kallistatin(t=7.632, P<0.001) in the AMI group were lower than those in the healthy control group, while the level of TP53 was higher(t=7.978, P<0.001). The serum levels of DJ-1(t=8.534, P<0.001) and Kallistatin(t=7.737, P<0.001) in the poor prognosis subgroup were lower than those in the good prognosis subgroup, while the level of TP53 was higher(t=7.382, P<0.001). Serum DJ-1 was positively correlated with Kallistatin levels, and serum TP53 was negatively correlated with DJ-1 and Kallistatin levels(r=0.513,-0.467,-0.451, all P<0.001). Low serum DJ-1 [OR(95%CI)=0.714(0.577-0.884)], low Kallistatin [OR(95%CI)=0.692(0.553-0.865)], and high TP53 [OR(95%CI)=2.315(1.296-4.135)] were risk factors for poor prognosis in AMI patients. The AUC values of serum DJ-1, Kallistatin, TP53 alone and their combination for predicting recurrent MACE in AMI patients were 0.795, 0.796, 0.807 and 0.917, respectively. The AUC of the combined three biomarkers was larger than that of each individual biomarker(Z=2.931, 2.900, 2.640, P=0.003, P=0.004, P=0.008). Conclusion In AMI patients with recurrent MACE after PCI, serum DJ-1 and Kallistatin levels are lower and TP53 levels are higher compared to those without recurrent MACE. The combined detection of these three biomarkers can effectively predict the risk of recurrent MACE in AMI patients after PCI.

Objective To investigate the expression and clinical significance of serum insulin-like growth factor binding protein 5(IGFBP5) and soluble osteoclast-associated receptor(sOSCAR) in young and middle-aged patients with acute myocardial infarction(AMI). Methods A total of 105 young and middle-aged AMI patients admitted to the Department of Cardiology, Xingtai Central Hospital from January 2021 to June 2023 were prospectively selected as the AMI group. According to the degree of coronary stenosis(Gensini score), they were divided into mild stenosis(<30 points, 32 cases), moderate stenosis(30-60 points, 42 cases), and severe stenosis(>60 points, 31 cases). Additionally, 60 healthy volunteers were selected as the healthy control group. The young and middle-aged AMI patients were further divided into poor and good prognosis subgroups based on their 24-month prognosis. Serum IGFBP5 and sOSCAR expression levels were detected by enzyme-linked immunosorbent assay. Pearson correlation analysis was used to analyze the correlation between serum IGFBP5, sOSCAR expression, and Gensini score. The relationship between serum IGFBP5 and sOSCAR expression and the prognosis of young and middle-aged AMI patients, as well as their predictive efficacy, were analyzed. Results Compared with the healthy control group, serum IGFBP5 expression was increased and sOSCAR expression was decreased in the AMI group(t/P=15.073/<0.001, 16.141/<0.001). Serum IGFBP5 expression increased sequentially, and sOSCAR expression decreased sequentially, across mild, moderate, and severe stenosis groups(F/P=268.737/<0.001, 87.294/<0.001). In young and middle-aged AMI patients, Gensini score was positively correlated with serum IGFBP5 expression and negatively correlated with sOSCAR expression(r/P=0.745/<0.001,-0.732/<0.001). The 12-month poor prognosis rate among the 105 young and middle-aged AMI patients was 40.00%(42/105). Gensini score, Killip grade ≥Ⅱ, and elevated IGFBP5 were independent risk factors for poor prognosis, while elevated sOSCAR was an independent protective factor [OR(95%CI) = 3.636(1.518-8.710), 2.754(1.141-6.647), 1.013(1.005-1.021), 0.987(0.987-0.997)]. The AUCs of serum IGFBP5 expression, sOSCAR expression, and their combination for predicting poor prognosis in young and middle-aged AMI patients were 0.784, 0.786, and 0.857, respectively. The combined prediction showed a larger AUC(Z/P=2.141/0.032, 2.348/0.019). Conclusion Serum IGFBP5 expression is increased and sOSCAR expression is decreased in young and middle-aged AMI patients, which is closely related to the aggravation of coronary stenosis and poor prognosis. The combined detection of serum IGFBP5 and sOSCAR has higher predictive efficacy for poor prognosis in young and middle-aged AMI patients.