Serum Expression of PDCD4 and ADAM10 in Elderly Patients with Atherosclerotic Acute Myocardial Infarction and Their Combined Predictive Value for Poor Prognosis.

Purpose: To investigate serum programmed cell death factor 4 (PDCD4) and a disintegrin and metalloproteinase 10 (ADAM10) expression in elderly patients with atherosclerotic acute myocardial infarction (AMI) and assess their prognostic value. Methods: A retrospective analysis was conducted on 134 elderly patients with atherosclerotic AMI (disease group) and 110 healthy controls. Serum PDCD4 and ADAM10 levels were measured using ELISA. Based on prognosis, patients were divided into good prognosis (n=79) and poor prognosis groups (n=55). Clinical factors and biomarker levels were compared between groups. Logistic regression identified independent predictors of poor prognosis, and receiver operating characteristic (ROC) curves assessed predictive performance. Results: Serum PDCD4 and ADAM10 levels were significantly higher in AMI patients compared with controls, and further elevated in the poor prognosis group (P<0.05). Poor prognosis was also associated with older age, diabetes, STEMI, larger infarct size, anterior wall infarction, higher Killip class and GRACE score, elevated NT-proBNP and hs-CRP, and reduced LVEF (P<0.05). Logistic regression confirmed elevated PDCD4 and ADAM10, diabetes, Killip class ≥II, GRACE score ≥140, STEMI, anterior infarction, NT-proBNP increase, and reduced LVEF as independent predictors of poor prognosis (P<0.05). ROC analysis showed AUCs of 0.837 for PDCD4, 0.859 for ADAM10, and 0.931 for their combination, with the combined model outperforming either marker alone (P<0.05). Conclusion: Serum PDCD4 and ADAM10 are elevated in elderly atherosclerotic AMI patients and independently associated with poor prognosis. Combined detection may provide improved prognostic assessment, although further studies are warranted to validate these findings.