Predictive value of plasma SCUBE-1,ADAMTS-9,and ANG-2 levels in acute pulmonary embolism severity and prognosis

ZHONG Pei-xiong; CHEN Yu; HAO Jin-xiang; WU Ting-shi; HUANG Yi-gui

doi:10.13820/j.cnki.gdyx.20240439

Abstract：Objective To investigate the predictive value of plasma signal peptide-CUB-epidermal growth fac-tor-like domain-containing protein 1(SCUBE-1),a disintegrin and metalloproteinase with thrombospondin motifs-9(ADAMTS-9),and angiopoietin-2(ANG-2)levels in assessing the severity and prognosis of acute pulmonary embol-ism(APE).Methods This study included 121 APE patients treated at our hospital.They were divided into mild(n=34,PAOI＜30％),moderate(n=45,30％≤PAOI≤50％),and severe(n=42,PAOI＞50％)groups based on the CT pulmonary artery obstruction index(PAOI).Based on prognosis,patients were divided into a good prognosis group(n=86)and a poor prognosis group(n=35).Plasma levels of SCUBE-1,ADAMTS-9,and ANG-2 were measured using enzyme-linked immunosorbent assay(ELISA).Multivariate logistic regression was used to analyze risk factors af-fecting poor prognosis in APE,and ROC curve analysis was performed to evaluate the predictive value of these plasma lev-els for poor prognosis.Pearson correlation analysis assessed the relationship between plasma levels and cardiac function in-dicators.Results The poor prognosis group had significantly higher plasma levels of SCUBE-1[(24.63±11.70)ng/mL vs.(10.17±5.12)ng/mL],ADAMTS-9[(47.50±13.25)ng/mL vs.(24.28±7.63)ng/mL],and ANG-2[(15.38±6.27)ng/mL vs.(4.15±1.52)ng/mL]compared to the good prognosis group(P＜0.001).Plasma levels of SCUBE-1,ADAMTS-9,and ANG-2 increased with APE severity,with levels in the severe group being the high-est,followed by the moderate and mild groups(P＜0.001).Multivariate logistic regression analysis showed that elevated levels of PAOI,CRP,cTnI,BNP,D-dimer,SCUBE-1,ADAMTS-9,and ANG-2 were risk factors for poor progno-sis in APE(all P＜0.05).ROC curve analysis indicated that the combined prediction of SCUBE-1,ADAMTS-9,and ANG-2 levels had the highest area under the curve(0.931,95％CI:0.868～0.996)with an accuracy of 88.4％.Correlation analysis demonstrated that plasma SCUBE-1,ADAMTS-9,and ANG-2 levels were positively correlated with CRP,cTnI,BNP,D-dimer,and PAOI(P＜0.05).Conclusion Elevated plasma levels of SCUBE-1,AD-AMTS-9,and ANG-2 are associated with increased severity and poor prognosis of APE.These markers are risk factors for poor prognosis in APE,and their combined measurement provides significant predictive value.