Predictive value of combined determination of serum SFRP5 and KLK1 for myocardial no-reflow after PCI in patients with ST-segment elevation myocardial infarction

doi:10.3969/j.issn.1673-8640.2025.01.015

Abstract

Abstract:

Objective To analyze the predictive value of combined determination of serum secreted frizzled-related protein-5（SFRP5） and Kallikrein 1（KLK1） for myocardial no-reflow after percutaneous coronary intervention（PCI） in patients with ST-segment elevation myocardial infarction（STEMI）. Methods A total of 156 STEMI patients underwent PCI and 156 healthy subjects in Nanning Eighth People's Hospital from January 2022 to July 2023 were enrolled. The clinical data and laboratory routine determination results of all the patients were collected，and serum SFRP5 and KLK1 levels were determined. STEMI patients were classified into reflow group [132 cases，the Thrombolysis in Myocardial Infarction（TIMI） grade 3] and no-reflow group（24 cases，TIMI grade 0-2） according to TIMI grades 3 months after PCI. Pearson correlation analysis was used to evaluate the correlation among the indicators. Multivariate Logistic regression was used to analyze the influencing factors of no-reflow after PCI in STEMI patients. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of serum SFRP5 and KLK1 in determining no-reflow after PCI in STEMI patients. Results Compared with healthy control group，serum SFRP5 and KLK1 levels in STEMI group were decreased before and after PCI（P<0.05）. Serum levels of SFRP5 and KLK1 in reflow group were higher than those in no-reflow group（P<0.001）. The creatine kinase-MB isoenzyme（CK-MB），cardiac troponin I（cTnI），platelet（PLT）count，Gensini scores and the Global Registry of Acute Coronary Events（GRACE）scores in reflow group were lower than those in no-reflow group（P<0.05）. Serum SFRP5 and KLK1 were negatively correlated with CK-MB，cTnI，PLT count，Gensini score and GRACE score（P<0.05）. Decreased SFRP5 and KLK1 were risk factors for STEMI patients without reflow after PCI [odds ratios（OR） were 0.514 and 0.601，95% confidence intervals（CI） were 0.374-0.707 and 0.435-0.831，respectively，P<0.05]. The areas under curves（AUC） of serum SFRP5 and KLK1 without reflow after PCI in STEMI patients were 0.881，0.885 and 0.949，respectively. Conclusions Serum levels of SFRP5 and KLK1 are lower in STEMI patients with myocardial no-reflow after PCI，and SFRP5 and KLK1 have certain predictive values for myocardial no-reflow in STEMI patients after PCI.

Key words: Secreted frizzled-related protein-5, Kallikrein 1, Acute myocardial infarction, Percutaneous coronary intervention, Myocardial no-reflow

CLC Number:

R446.1

CHEN Dingzhong, YANG Wen, FENG Yanju, LIANG Xian, ZHANG Xiaozhen. Predictive value of combined determination of serum SFRP5 and KLK1 for myocardial no-reflow after PCI in patients with ST-segment elevation myocardial infarction[J]. Laboratory Medicine, 2025, 40(1): 84-89.

Figures/Tables 7

References 21

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组别	例数	SFRP5/（ng·mL^-1）	KLK1/（ng·L^-1）
正常对照组	156	43.83±4.12	35.26±3.04
STEMI组	156
术前		32.71±3.85^*	24.77±2.93^*
术后		33.18±3.97^*	25.34±3.06^*

组别	例数	SFRP5/（ng·mL^-1）	KLK1/（ng·L^-1）
正常对照组	156	43.83±4.12	35.26±3.04
STEMI组	156
术前		32.71±3.85^*	24.77±2.93^*
术后		33.18±3.97^*	25.34±3.06^*

组别	例数	SFRP5/（ng·mL^-1）	KLK1/（ng·L^-1）
复流组	132	33.72±4.07	25.68±3.47
无复流组	24	27.16±2.42	19.75±2.51
t值		7.642	7.991
P值		<0.001	<0.001

组别	例数	SFRP5/（ng·mL^-1）	KLK1/（ng·L^-1）
复流组	132	33.72±4.07	25.68±3.47
无复流组	24	27.16±2.42	19.75±2.51
t值		7.642	7.991
P值		<0.001	<0.001

组别	例数	性别			年龄/岁		BMI/（kg·m^-2）			基础疾病
组别	例数	男/[例（%）]	女/[例（%）]		年龄/岁		BMI/（kg·m^-2）			高血压/ [例（%）]			糖尿病/ [例（%）]	高脂血症/[例（%）]
复流组	132	105（79.55）	27（20.45）		54.74±7.91		24.32±2.56			45（34.09）			33（25.00）	34（25.76）
无复流组	24	18（75.00）	6（25.00）		54.82±7.98		24.41±2.71			11（45.83）			7（29.17）	9（37.50）
统计值		0.252			0.046		0.157			1.217			0.185	1.402
P值		0.616			0.964		0.875			0.270			0.667	0.236
组别	发病至手术时间/h	吸烟史/ [例（%）]		饮酒史/ [例（%）]		GRACE评分/分		Gensini积分/分			CK-MB/（U·L^-1）			cTnI/ （μg·L^-1）
复流组	6.11±0.85	42（31.82）		49（37.12）		118.56±13.85		69.83±13.25			172.36±37.15			10.75±2.73
无复流组	6.13±0.93	9（37.50）		8（33.33）		127.05±15.17		91.47±14.38			191.47±41.63			12.13±3.15
统计值	0.105	0.298		0.126		2.722		7.264			2.275			2.224
P值	0.917	0.585		0.723		0.007		<0.001			0.024			0.028
组别	Myo/ （μg·L^-1）	BNP/（pg·mL^-1）	PLT计数/（×10⁹·L^-1）		WBC计数/（×10⁹·L^-1）				SCr/（μmol·L^-1）			Cys C/（mg·L^-1）	Hcy/（μmol·L^-1）	DD/ （μg·L^-1）
复流组	186.12±20.14	1122.75±214.32	214.75±32.56		10.42±3.72				121.28±31.51			4.49±1.26	35.32±5.39	325.71±50.76
无复流组	187.25±20.23	1140.53±223.57	232.47±33.61		10.53±3.75				130.15±27.29			5.02±1.41	37.21±5.28	328.43±52.51
统计值	0.253	0.371	2.441		0.133				1.293			1.861	1.585	0.240
P值	0.801	0.711	0.016		0.894				0.198			0.065	0.115	0.810