ObjectiveTo explore the predictive value of combined detection of serum glucose regulated protein 78 (GRP78), insulin-like growth factor binding protein-6 (IGFBP-6), and clusterin for poor prognosis in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI).MethodsThis study selected 360 AMI patients who were treated at North China Medical Health Group Fengfeng General Hospital from January to December, 2023. All patients underwent one year of follow-up after PCI. Based on their prognosis during the follow-up period, patients were grouped into a good prognosis group (265 cases) and a poor prognosis group (95 cases). Enzyme-linked immunosorbent assay (ELISA) was applied to detect serum levels of GRP78, IGFBP-6, and clusterin. Color Doppler echocardiography was applied to detect left ventricular ejection fraction (LVEF) level in all patients. Chemiluminescence immunoassay was used to detect the levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), cardiac troponin I (cTnI), creatine kinase-MB (CK-MB), and glycated hemoglobin (HbA1c). Multivariate Logistic regression analysis was used to analyze the influencing factors of poor prognosis in AMI patients after PCI. Pearson correlation analysis was used to analyze the correlation between serum GRP78, IGFBP-6, and clusterin levels in the poor prognosis group. Receiver operating characteristic (ROC) curve analysis was used to analyze the diagnostic value of serum GRP78, IGFBP-6, and clusterin levels for poor prognosis in AMI patients after PCI.ResultsThe heart rate and LVEF in the poor prognosis group were lower than those in the good prognosis group, while the serum levels of HbA1c, NT-proBNP, cTnI, CK-MB, GRP78, IGFBP-6, and clusterin were higher than those in the good prognosis group (P < 0.05). cTnI, GRP78, IGFBP-6, and clusterin were risk factors for poor prognosis in AMI patients after PCI [OR(95%CI)=1.473(1.040-2.088), 1.346(1.079-1.680), 1.742(1.121-2.708), 1.624(1.061-2.485); all P < 0.05]. There was a positive correlation between GRP78 and IGFBP-6, GRP78 and clusterin, and IGFBP - 6 and clusterin (r=0.426, 0.571, 0.551; P < 0.05) in the poor prognosis group. The areas under the curve (AUCs) of serum GRP78, IGFBP-6, and clusterin for predicting poor prognosis in AMI patients after PCI were 0.794, 0.742, and 0.790, respectively. The AUC of the combined diagnosis of the three was 0.913, which was better than the individual diagnosis (Z=4.695, 6.237, 5.241;P < 0.05).ConclusionSerum levels of GRP78, IGFBP-6, and clusterin are upregulated in AMI patients with poor prognosis after PCI. Each is a risk factor for poor post-PCI prognosis in AMI patients and demonstrates predictive value for poor prognosis in AMI patients after PCI. The combination of all three biomarkers shows superior predictive value.