Predictive value of serum ACSL4 and SⅡ levels for no-reflow phenomenon during PCI in patients with acute ST-seg-ment elevation myocardial infarction complicated by HFpEF
Zhang Qinglong
He Ting
Yang Qi
Wang Jinbo
He Xuesong
Pan Xiaodong
Abstract：Objective To investigate the predictive value of serum acyl-CoA synthetase long-chain family member 4(ACSL4)and systemic immune-inflammation index(SⅡ)levels for no-reflow phenomenon during percutaneous coronary in-tervention(PCI)in patients with acute ST-segment elevation myocardial infarction(ASTEMI)complicated by heart failure with preserved ejection fraction(HFpEF).Methods This study included 135 ASTEMI patients with HFpEF(observation group)who underwent PCI at The Second Affiliated Hospital of Anhui Medical University from October 2019 to June 2024,and 70 healthy volunteers(control group).The ASTEMI patients were further divided into no-reflow subgroup(n=33)and reflow subgroup(n=102)based on coronary flow during PCI.Serum ACSL4 and SⅡ levels were compared among groups.Multivariate unconditional Logistic regression was used to identify risk factors for no-reflow.Receiver operating characteris-tic(ROC)curve analysis was performed to evaluate the predictive value of serum ACSL4 and SⅡ levels for no-reflow.Results Compared with controls,the observation group showed higher serum ACSL4 and SⅡ levels(t/P=21.858/＜0.001,13.649/＜0.001).The no-reflow rate during PCI was 24.44％(33/135).The no-reflow subgroup had higher ACSL4 and SⅡ levels than the reflow subgroup(t/P=5.877/＜0.001,5.324/＜0.001).Patients in no-reflow subgroup were older,with higher proportions ofKILLIP class Ⅳ,NT-proBNP and LDL-C levels(x2/t/P=3.610/＜0.001,2.993/0.003,3.782/0.005,2.109/0.037).Advanced age,high ACSL4,and high SⅡ were independent risk factors for no-reflow[OR(95％CI)=1.123(1.022-1.243),1.207(1.082-1346),1.003(1.002-1.005)].The AUC values for predicting no-reflow using ACSL4,SⅡ,and their combination were 0.786,0.797,and 0.879 respectively,with combined detection showing superior predictive value(Z/P=2.474/0.010,2.726/0.004).Conclusion Elevated serum ACSL4 and SⅡ levels are closely associated with no-reflow during PCI in ASTEMI patients with HFpEF.Combined detection of these biomarkers shows high predictive value.
Keywords：Acute ST-segment elevation myocardial infarctionHeart failure with preserved ejection fractionAcyl-CoA synthetase long-chain family member 4Systemic immune-inflammation indexPercutaneous coronary interventionNo-reflowPredictive value
Publication Date：2025-04-18
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 428-433 )