Objective To investigate the relationships of serum levels of leukocyte cell-derived chemotaxin 2 (LECT2), A disintegrin and metalloproteinase with thrombospondin motifs 9 (ADAMTS9) with disease severity and prognosis in patients with acute myocardial infarction (AMI).

Methods A total of 112 AMI patients admitted to Geriatric Function Department of Health Care Institute of the People's Hospital of Inner Mongolia Autonomous Region from January 2020 to April 2022 were prospectively selected as AMI group. Based on occurrence of major adverse cardiovascular events (MACE) during a 6-month follow-up, the AMI patients were further divided into MACE group (n=30) and non-MACE group (n=82). Sixty healthy individuals undergoing physical examinations during the same period were selected as control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum levels of LECT2 and ADAMTS9. Pearson correlation analysis was employed to explore the relationships of serum levels of LECT2 and ADAMTS9 with cardiac function indicators in AMI patients.Logistic regression analysis was used to investigate influencing factors of MACE occurrence in AMI patients. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of serum levels of LECT2 and ADAMTS9 for MACE occurrence in AMI patients.

Results The serum levels of LECT2 and ADAMTS9 in the AMI group were significantly higher than those in the control group (P < 0.001). The incidence of MACE during the 6-month follow-up in 112 AMI patients was 26.79% (30/112). The serum levels of LECT2 and ADAMTS9 in the MACE group were significantly higher than those in the non-MACE group (P < 0.001). Compared with the non-MACE group, the MACE group had a higher number of coronary artery lesions and a higher Killip classification, while left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), and cardiac output (CO) were significantly lower (P < 0.05). Serum levels of LECT2 and ADAMTS9 in AMI patients were significantly negatively correlated with LVEF, LVFS, and CO, and significantly positively correlated with Killip classification (P < 0.001). Multivariate Logistic regression analysis showed that high LECT2, high ADAMTS9, and high Killip classification were risk factors for MACE occurrence in AMI patients, while high LVEF was a protective factor (P < 0.001). The areas under the curve (AUCs) for predicting MACE occurrence in AMI patients by serum levels of LECT2, ADAMTS9, and their combination were 0.860, 0.818, and 0.940, respectively. The AUC of the combined prediction was higher than that of the single-factor prediction by serum levels of LECT2 and ADAMTS9 (Z= 4.186, P=0.002; Z=5.469, P < 0.001).

Conclusion Elevated serum levels of LECT2 and ADAMTS9 in AMI patients are associated with disease severity. Their combined prediction of MACE occurrence in AMI patients has potential application value.