| Background: Coronary atherosclerotic heart disease is called coronary heartdisease(CHD) for short, and it is one of the most common organ leisions caused byatherosclerosis. with the continuous increase of coronary heart disease morbidity andmortality, CHD has become one of the major diseases which do harm to human health.Acute coronary syndrome (ACS) is a severe coronary heart disease, charactered by itsrapid development and high disability and death rate. It is vital saving lives andimproving the prognosis to early judgment of coronary heat disease especially acutecoronary syndrome patient condition and then active treatment. Animal studies haveshown that follistatin like protein1/follistatin-like1(FSTL1) is secreted by cardiacmyocyte, and as a cardiac secreted protein, expression levels of FSTL1are upregulatedin rodent models of myocardial infarction or cardiac pressure overload. Meanwhile,FSTL1overexpression will protect cardiac myocytes from ischemia/reperfusion-induced apoptosis. Recently studies have shown that FSTL1concentrations are relatedto the risk of all-cause mortality in patients with acute coronary syndrome. FSTL1is anindependent risk factor related to ACS patients death. FSTL1, as a biochemical marker,can predict high-risk ACS patients. At present, although the value of FSTL1clinicalapplications have received increasing attention in the cardiovascular field, furtherstudies on the relation between FSTL1and cardiovascular disease are still needed. Weexplore the related factors which affect ACS patients FSTL1concentration in this study,and provide a reference for FSTL1clinical application.Objective: To observe the FSTL1concentrations between patients with CHD andnormal control group, and to explore the relation between the serum FSTL1concentrations and coronary heart disease risk factors, serum high sensitivity C-reactiveprotein (hs-CRP)，N terminal proB-type natriuretic peptide (NT-proBNP)，coronaryartery stenosis extent in patients with ACS.Methods:178inpatients were recruited at our hospital between August2009and May2010, including148patients with CHD confirmed by coronary angiography (CAG) and30patients with CAG negtive (normal control group, NC, n=30) at the same time.148patients were assigned into4subgroups according to stable angina pectoris group (SAP, n=25), unstable angina pectoris group (UAP, n=43), Non-ST-segment elevation acutemyocardial infarction group (NSTEMI, n=34), ST-segment elevation acute myocardialinfarction group (STEMI, n=46), and patients with ACS were assigned by CAG intosigle, double and mutivessel coronary atery disease group. All patients provided writteninformed consent. Peripheral vein blood of all patients were collected on admission. SerumFSTL1and NT-proBNP levels were measured by Enzyme Linked ImmunosorbentAssay (ELISA), And hs-CRP was measured by immunoturbidimetry in laboratory. Themeasurement data were expressed as x±s or M (P25, P75), and count data wereexpressed count number. The SPSS17.0software was used for statistical analysis. Thetwo side P value<0.05was considered statistically significant.Results:(1)The difference of serum FSTL1concentrations between the NC and SAPgroup were not significant [4.08(2.47,4.78) ng/ml vs4.22(3.04,5.07) ng/ml, P＞0.05].The difference of serum FSTL1concentrations among the UAP, NSTEMI and STEMIgroup were also not significant [10.45(8.89,14.30) ng/ml vs9.08(7.42,12.66) ng/ml vs10.30(8.65,13.60) ng/ml, P＞0.05]. Serum FSTL1levels in UAP, NSTEMI and STEMI groupwere higher than those from NC and SAP group [10.45(8.89,14.30) ng/ml,9.08(7.42,12.66)ng/ml,10.30(8.65,13.60) ng/ml vs4.08(2.47,4.78) ng/ml，4.22(3.04,5.07) ng/ml, P＜0.01].(2) Serum FSTL1concentrations in patients with ACS were not correlated with CHD riskfactors (such as age, gender, hypertension, hyperlipemia, diabetes mellitus and so on). Serum FSTL1levels were positively related to serum hs-CRP (r=0.500, P=0.007), NT-proBNP (r=0.578, P=0.012)levels respectively in patients with ACS.(3) Serum FSTL1concentrations were related toincreasing coronary vessel disease extent in patients with ACS (P＜0.01, for trend). Serum FSTL1concentrations (LnFSTL1) in single-vessel, double-vessel and mutivessel group were (2.38±0.28),(2.43±0.26),(2.57±0.29) respectively. With the number of diseased coronary vesselincreasing, serum FSTL1concentrations were elevating. There were statisticalsignificance among those groups (F=5.25, P=0.007).Conclusions:(1) Serum FSTL1concentrations in patients with ACS are not correlated with CHDrisk factors such as age, gender, hypertension, hyperlipemia, diabetes mellitus and so on.(2) SerumFSTL1concentrations may partly reflect the extent of coronary artery disease, severity of ACSpatients. It is of clinical signifcance for judging prognosis in patients with ACS. |
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