Relationship of pan-immune inflammation value and variation rate of C-reactive protein with myocardial fibrosis and postoperative remodeling in elderly patients with acute myocardial infarction
10.3969/j.issn.1009-0126.2025.11.015
- VernacularTitle:泛免疫炎症指数和C反应蛋白变化率与老年急性心肌梗死患者心肌纤维化及术后重构的关系
- Author:
Zheng LU
1
;
Jinhai WU
1
;
Yun JIA
1
;
Juxin ZHAO
1
Author Information
1. 南阳市第一人民医院急诊科,河南南阳 473000
- Publication Type:Journal Article
- Keywords:
myocardial infarction;
C-reactive protein;
ventricular remodeling;
pan-immune inflammation value
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2025;27(11):1512-1516
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the correlation of pan-immune inflammation value(PⅡV)and C-reactive protein variation rate(ΔCRP)with myocardial fibrosis in elderly patients with acute myocardial infarction(AMI).Methods A total of 123 elderly AMI patients admitted to our department from January 2022 to July 2024 were enrolled,and then followed up for 6 months postoperatively.According to occurrence of ventricular remodeling or not,they were divided into a remodeling group(26 cases)and a non-remodeling group(97 cases),and based on presence of myocardial fibrosis,they were also assigned into a fibrosis group(31 cases)and a non-fibrosis group(92 cases).Cardiac MRI was performed after admission to diagnose myocardial fibrosis.PⅡV,ΔCRP,type Ⅲ procollagen N-terminal peptide(PⅢNP),and type Ⅰ collagen C-terminal peptide(CICP)levels were compared between the fibrosis and non-fibrosis groups.Pearson correlation analysis was used to assess the relationships of PⅡV and ΔCRP with PⅢNP and CICP.Multivariate logistic regression analysis was applied to identify factors influencing postoperative remodeling.ROC curve analysis was conducted to evaluate the clinical efficacy of PⅡV and ΔCRP in predicting postoperative remodeling.Results The fibrosis group exhibited significantly higher PⅡV,ΔCRP,PⅢNP,and CICP levels than the non-fibrosis group(P＜0.05,P＜0.01).Pearson analysis revealed positive correlations between PⅡV and PⅢNP/CICP(r=0.458,r=0.533,P＜0.01)and between ΔCRP and PⅢNP/CICP(r=0.591,r=0.627,P＜0.01).The remodeling group had obviously higher PⅡV(400.81±71.73 vs 335.45±71.19,t=4.151,P＜0.01)and ΔCRP[1.19±0.30 mg/(L·h)vs 0.90±0.15 mg/(L·h),t=6.878,P＜0.01]than the non-remodeling group.Multivariate logistic regression analysis identified age(OR=3.196,95％CI:1.597～6.398,P＜0.01),coronary Gensini score(OR=1.966,95％CI:1.295～2.984,P＜0.01),PⅡV(OR=3.470,95％CI:1.621～7.427,P＜0.01),and ΔCRP(OR=2.889,95％CI:1.431～5.836,P＜0.01)as risk factors for postoperative remodeling,while out-hospital medication adherence was a protective factor(OR=0.489,95％CI:0.319～0.748,P＜0.01).ROC curve analysis showed an AUC value of PⅡV,ΔCRP and their combination in the prediction was 0.735,0.778 and 0.905,respectively,with the combined two indicators having better efficiency(P＜0.01).Conclusion PⅡV and ΔCRP are closely associated with myocardial fibrosis and postoperative ventricular remodeling in elderly AMI patients.Combined detection of these two markers can optimize risk stratification and provide critical insights for clinical intervention.
