The plasma level of Gelsolin and its clinical significance in patients with acute ST-elevation myocardial infarction

Objective To explore the level of plasma Gelsolin (pGSN) in patients with acute ST-segment elevation myocardial infarction (STEMI) as a useful marker for myocardial infarction, reperfusion injury, effect of primary percutaneous coronary intervention (pPCI) and its short-term prognostic value . Methods A total of 126 patients with first onset of STEMI undergoing pPCI and 60 patients with stable angina pectoris (SAP) receiving elective PCI were enrolled in this study.pGSN was measured using ELISA before and 90 min after PCI, and then calculated the change of pGSN(ΔG). pGSN was also measured in another 30 healthy controls.STEMI patients were divided into two groups: complete ST-segment depression (ST≥70%) and incomplete ST-segment depression (STR <70%). The patients′ surgery, laboratory findings, and all cardiac adverse events (MACE) within 3 months after PCI were recorded.SPSS-20.0 was used for statistical analysis. Results (1) Baseline level of pGSN in STEMI group was significantly lower than healthy group or SAP group [(104.51±35.91) ng/ml vs.(129.47±41.61) ng/ml and (138.17±43.43) ng/ml, F=9.641, P<0.01] , while there was no significant difference between healthy group and SAP group.(2) The level of pGSN was changed significantly after PCI in STEMI group [(95.42±36.50) ng/ml vs. (104.51±35.91) ng/ml, t=4.959, P<0.01], while there was no statistical change in SAP group.(3) ΔG was significantly higher in incomplete STR group than in complete STR group [(5.37±5.14) ng/ml vs. (1.92±4.46) ng/ml, F=0.938, P=0.007]. (4) The area of pGSN under the receiver operator characteristic curve was 0.742 (95%CI: 0.638-0.826, P<0.01). When taking pGSN=96.13 ng/ml as cutoff point, the sensitivity and specificity in diagnosing STEMI were 54.8% and 80.6%, respectively.(5) There was significant difference of pGSN [(82.28±23.56) ng/ml vs.(108.35±30.13) ng/ml, F=0.281, P=0.021] and ΔG [(6.87±6.22) ng/ml vs. (3.25±4.14) ng/ml, F=3.276, P=0.008] between MACE group and non-MACE group.Multivariate Cox stepwise regression indicated that pGSN was one of the independent predictors of MACE within 3 months. Conclusions The level of pGSN could be a good serum marker for patients with STEMI.The early changes of pGSN after PCI may be an indicator to assess the degree of myocardial ischemia-reperfusion injury, and have a predictive value for adverse cardiovascular events in such patients within 3 months. Key words: Plasma gelsolin; Myocardial infarction; Myocardial reperfusion injury