The Relationship Between Microvascular Density and Arrhythmia in Patients with Acute Myocardial Infarction

LIU Yi; LIU Jun; LIU Guofang

doi:10.12102/j.issn.1672-1349.2025.19.017

Abstract：Objective: To explore the relationship between microvascular density (MVD) and arrhythmia (MVA) in patients with acute myocardial infarction (AMI) and their impact on prognosis. Methods: A total of 254 AMI patients admitted to Wuhan City First People's Hospital, Hubei Province from January 2021 to September 2022 were selected and divided into acute ST-segment elevation myocardial infarction (STEMI) group and acute non-ST-segment elevation myocardial infarction (NSTEMI) group according to the type of myocardial infarction. The STEMI group had 148 cases, and the NSTEMI group had 106 cases. Multivariate Cox regression analysis was used to identify risk factors for MVA in AMI patients. A nomogram was established using R software, and a risk stratification system was built based on scoring using recursive partitioning. Results: Univariate analysis showed statistically significant differences in body mass index (BMI), smoking history, alcohol history, hypertension history, diabetes history, hyperlipidemia history, heart rate, procalcitonin (PCT), C-reactive protein (CRP), D-dimer (D-D), brain natriuretic peptide (BNP), serum heme oxygenase-1 (HO-1), thioredoxin (Trx1), superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GSH-Px), and advanced oxidation protein products (AOPP) between the two groups (P < 0.05). Multivariate logistic regression analysis showed that hypertension history, D-D, BNP, SOD, MDA, AOPP, and MVD were risk factors for MVA in AMI patients (P < 0.05), while HO-1, Trx1, and GSH-Px were protective factors (P < 0.05). In stepwise regression analysis, MVD had the strongest predictive ability for the risk of MVA after AMI, and Trx1, BNP, SOD, MDA, GSH-Px, and hypertension history had high predictive value. MVA was independently related to SOD, MDA, and AOPP (P < 0.05), but not related to GSH-Px (P > 0.05). As the levels of SOD, MDA, and AOPP increased, the risk of MVA in patients increased. The area under the receiver operating characteristic (ROC) curve (AUC) of the nomogram model was 0.925 before validation and 0.921 after validation, with an average calibration error of 0.012. Conclusion: Elevated MVD levels in AMI patients significantly increase the risk of MVA, and MVD is the best predictor of MVA risk. Measuring MVD levels in AMI patients is of great significance for MVA.