The expression of serum sTREM-1 and DPP3 levels in patients with acute coronary syndrome complicated with car-diogenic shock and their correlation with prognosis

Yang Muyuan; Xu Ting; Zhou Pingping; Li Qiao; Ouyang Guo; Li Zhibin

doi:10.3969/j.issn.1671-6450.2025.11.010

Abstract：Objective To investigate the expression levels of serum soluble triggering receptor expressed on myeloid cells-1(sTREM-1)and dipeptidyl peptidase Ⅲ(DPP3)in patients with acute coronary syndrome(ACS)complicated with car-diogenic shock(CS)and their relationship with prognosis.Methods A total of 137 patients with ACS complicated with CS admitted to the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from January 2021 to December 2024 were selected as the ACS-CS group.According to 28-day survival after admission,patients were divided into a survival subgroup(n=86)and a death subgroup(n=51).Additionally,137 patients with uncomplicated ACS during the same period were selected as the ACS group,and 137 healthy subjects were enrolled as the healthy control group.Serum sTREM-1 and DPP3 levels were measured by enzyme-linked immunosorbent assay.Spearman rank correlation was used to analyze the corre-lation between serum sTREM-1,DPP3 levels and CS severity.Cox proportional hazards regression was used to analyze factors influencing prognosis and death in ACS patients with CS.The receiver operating characteristic(ROC)curve was applied to evaluate the predictive value of serum sTREM-1 and DPP3 levels for the risk of death in ACS patients with CS.Results Ser-um sTREM-1 and DPP3 levels in the ACS-CS group and ACS group were higher than those in the healthy control group,and levels in the ACS-CS group were higher than those in the ACS group(P＜0.05).Serum sTREM-1 and DPP3 levels in the typi-cal phase,deterioration phase,and end-stage phase were higher than those in the risk phase and initial phase,and levels in the deterioration and end-stage phases were higher than those in the typical phase(P＜0.05).Serum sTREM-1 and DPP3 were pos-itively correlated with disease severity(rs/P=0.516/0.001,0.559/0.001).Compared with the risk phase,the risk of death in-creased in patients in the typical phase,deterioration phase,and end-stage phase(HR=1.445,2.670,6.633,P＜0.05).Elevated LVEF was a protective factor against death(HR=0.875,P＜0.05),while elevated sTREM-1 and elevated DPP3 were independ-ent risk factors(HR=1.626,1.714,P＜0.05).The AUC values of serum sTREM-1,DPP3,and their combination in predicting the risk of death were 0.866,0.859,and 0.935,respectively.The combined predictive value was greater than that of either sin-gle indicator(Z/P=2.089/0.036,2.192/0.028).Conclusion Serum sTREM-1 and DPP3 expression is upregulated in patients with ACS complicated with CS and is closely related to CS severity and prognosis.Early combined detection may serve as a potential biomarker for assessing disease status and predicting prognosis.