Abstract： Objective To investigate the correlation of serum ceatine kinase isoenzyme (CK-MB), myocardial myoglobin (MYO) levels, and thrombelastogram (TEG) indexes[coagulation reaction time (R), blood coagulation time (K), Angle and maximal amplitude (MA) ] with the severity of acute myocardial infarction (AMI). To explore the value of the combined detection of the above indexes in predicing major adverse cardiovascular events (MACE) among patients with AMI. Methods A total of 117 patients with AMI were selected as AMI group while another 110 healthy physical examinees during the same period were selected as control group. AMI patients were divided into 4 classes according to Killip classification. According to the presence or absence of MACE within one year after treatment, AMI patients were divided into MACE and non-MACE subgroups. The serum CK-MB and MYO levels, and TEG indexes of R, K, Angle and MA at admission were compared between AMI group and control group, and among AMI patients with different Killip classes, respectively. The correlation of the above indexes with Killip classes was analyzed. The serum levels of CK-MB and MYO, and TEG indexes of R, K, Angle and MA at admission were compared between MACE and non-MACE subgroups. ROC curve was utilized to analyze the predictive value of the combined detection of the above indexes on the occurrence of MACE in AMI patients. Results The serum levels of CK-MB and MYO, and TEG indexes of Angle and MA in the AMI group were all higher than those in the control group while TEG indexes of R and K were both lower than those in the control group (P<0.05). The serum levels of CK-MB and MYO, and TEG indexes of Angle and MA were compared among the AMI patients with different Killip classes: Class Ⅳ> Class Ⅲ>Class Ⅱ> Class Ⅰ(P<0.05). The TEG indexes of R and K were also made comparison: Class Ⅰ>Class Ⅱ>Class Ⅲ>Class Ⅳ (P<0.05). Serum levels of CK-MB and MYO, and TEG indexes of Angle and MA were positively correlated with Killip classification while TEG indexes of R and K were negatively correlated with Killip classification (P<0.05). At admission, the serum levels of CK-MB and MYO, and TEG index of Angle and MA in the MACE subgroup were all higher than those in the non-MACE subgroup; the TEG indexes of R and K were both lower than those in the non-MACE group (P<0.05). The AUC and sensitivity of the combined detection of serum levels of CK-MB and MYO, and TEG indexes of R, K, Angle and MA at admission for predicting MACE in AMI patients were 0.895 and 83.17%, respectively, which were significantly higher than those of any of the above indexes alone (P<0.01). Conclusion Serum levels of CK-MB and MYO, and TEG indexes of R, K, Angle and MA can be used to evaluate the severity of AMI. These indexes are significantly correlated with Killip classification. The combined detection of the above indexes has a high diagnostic efficacy in predicting the occurrence of MACE in AMI patients.
耿明明,潘晨,杨惠惠. 血清CK-MB、MYO与TEG指标联合检测对急性心肌梗死患者不良预后的预测价值[J]. 实用心电学杂志, 2024, 33(3): 258-263.
GENG Mingming, PAN Chen, YANG Huihui. Value of combined detection of serum CK-MB, MYO and TEG indexes in predicting poor prognosis of patients with acute myocardial infarction. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2024, 33(3): 258-263.
