Clinical observation of 24-hour dynamic electrocardiogram combined with serum AnxA1 and endothelial microparticle testing in the diagnosis of myocardial ischemia in patients with coronary heart disease without typical symptoms
10.3760/cma.j.cn341190-20240814-01039
- VernacularTitle:24 h动态心电图联合血清AnxA1、EMP检查诊断无典型症状冠心病心肌缺血的临床研究
- Author:
Xiaohui GUO
1
;
Jingyu LI
1
Author Information
1. 郑州市第三人民医院心电图室，郑州 450000
- Publication Type:Journal Article
- Keywords:
Coronary disease;
Myocardial infarction;
Computed tomography angiography;
annexin A1;
Electrocardiography，ambulatory
- From:
Chinese Journal of Primary Medicine and Pharmacy
2025;32(3):404-408
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical value of 24-hour dynamic electrocardiogram combined with serum Annexin A1 (AnxA1) and endothelial microparticle (EMP) testing in the diagnosis of myocardial ischemia in patients with coronary heart disease without typical symptoms.Methods:A retrospective analysis was conducted on the clinical data of 80 patients with suspected coronary heart disease with myocardial ischemia and atypical symptoms who were admitted to The Third People's Hospital of Zhengzhou from January 2021 to April 2024. Based on the results of coronary angiography (CAG), patients were divided into groups: those with positive CAG results were assigned to the study group ( n = 49), while those with negative CAG results were assigned to the control group ( n = 31). The general clinical data, serum AnxA1 and EMP levels, duration of myocardial ischemia episodes, and the timing of ST-segment depression during myocardial ischemia were compared between the two groups. The efficacy, sensitivity, and specificity of each indicator for diagnosing myocardial ischemia in coronary heart disease without typical symptoms were analyzed using receiver operating characteristic curves. Results:In the study group, serum AnxA1 and EMP levels were (3.38 ± 1.02) μg/L and (1 415 ± 210) × 10 6/Ls, respectively, which were significantly higher than those in the control group, where the levels were (0.38 ± 0.11) μg/L and (1 179 ± 119) × 10 6/Ls ( t = 16.28, 5.70, both P < 0.05). Additionally, the duration of myocardial ischemia episodes in the study group was (275.17 ± 53.98) seconds, significantly longer than the (240.69 ± 44.58) seconds observed in the control group ( t = 2.97, P < 0.05). Receiver operating characteristic curve analysis results demonstrated the clinical value of the 24-hour dynamic electrocardiogram, serum AnxA1 and EMP levels, individually and in combination, for diagnosing myocardial ischemia in coronary heart disease without typical symptoms. Notably, the combined application showed the highest diagnostic efficacy, with an area under the curve of 0.961, a sensitivity of 0.980, and a specificity of 0.677. Conclusions:The use of 24-hour dynamic electrocardiogram and serum AnxA1 and EMP testing for the diagnosis of myocardial ischemia in coronary heart disease without typical symptoms all have certain clinical value, and the combined application shows even greater diagnostic effectiveness than a single application.
