Objective To explore the clinical value of serum Gal-3/Apelin-13 in predicting coronary microcirculation dysfunction (CMD) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI).

Methods A total of 173 patients who underwent emergency PCI for AMI were selected as the study subjects. According to the occurrence of CMD after the procedure, they were divided into control group (non-CMD patients, n=113) and study group (CMD patients, n=60). General data, serum Gal-3 and Apelin-13 levels, coronary angiography (CAG) parameters and the index of microcirculatory resistance (IMR) were analyzed in the two groups. Pearson and Spearman correlation analyses were used to investigate the correlations of serum Gal-3 and Apelin-13 levels with CMD. Multivariate logistic regression analysis was employed to screen for the influencing factors of post-procedure CMD. Receiver operating characteristic (ROC) curves were plotted to analyze the clinical value of serum Gal-3 and Apelin-13 in predicting CMD.

Results The proportion of patients with multiple vessel lesions and Killip grade ≥Ⅱ in the study group was significantly higher, and the time from onset to admission and the total length of stents were significantly longer than those in the control group (P < 0.05). The levels of serum Gal-3 and IMR in the study group were significantly higher, while the level of serum Apelin-13 was significantly lower than that in the control group (P < 0.001). Pearson correlation analysis showed that serum Gal-3 was positively correlated with IMR in patients after emergency PCI for AMI (P < 0.05), and serum Apelin-1 was negatively correlated with IMR (P < 0.05). Spearman correlation analysis showed that serum Gal-3 in patients after emergency PCI for AMI was negatively correlated with myocardial perfusion grade (TMPG) in the thrombolysis test for myocardial infarction and positively correlated with thrombus burden score (P < 0.05); serum Apelin-13 was positively correlated with TMPG and negatively correlated with thrombus burden score (P < 0.05). The results of Logistic analysis showed that combined multiple vessel lesions, Killip grade ≥ grade Ⅱ, delayed time from onset to admission, total stent length, serum Gal-3 level and serum Apelin-13 level were the influencing factors of CMD in patients after emergency PCI for AMI (P < 0.05). The area under the curve (AUC) of serum Gal-3, Apelin-13 and their combined prediction for CMD in patients after emergency PCI for AMI was 0.70, 0.760 and 0.864, respectively. Among them, the AUC predicted by the combined prediction was greater than that predicted by Gal-3 and Apelin-13 alone (P < 0.05).

Conclusion Elevated serum Gal-3 level and decreased serum Apelin-13 level are closely related to CMD in patients after emergency PCI for AMI. Moreover, combined multiple vessel lesions, Killip grade ≥ grade Ⅱ, delayed time from onset to admission and longer total stent length are risk factors for postoperative CMD. The combined prediction of serum Gal-3 and Apelin-13 has a relatively high value in predicting the occurrence of CMD in AMI patients after PCI.