Non-high-density Lipoprotein Cholesterol And Fibrinogen Predict The Severity Of Coronary Bifurcation Lesions

Objective: To study of the relationship between non-high-density lipoprotein cholesterol( non-HDL-C), fibrinogen( FIB) and coronary bifurcation lesions. To explore the predictive value of non-HDL-C and FIB in coronary bifurcation lesions.Method:To select 704 consecutive first hospitalization patients with acute coronary syndrome, which the diagnosis had been confirmed by coronary angiography and clinical manifestation were enrolled in this study from January 2008 to 2012 in The Second Affiliated Hospital of Dalian Medical University. Exclusion criteria:(1)Coronary artery stenosis< 50%, merging other cardiovascular diseases, such as severe heart failure, rheumatic valvular heart disease, cardiomayopathy, and aortic dissection;(2)Underwent coronary revascularization( past history of coronary artery bypass grafting or treatment of coronary intervention);(3)Merging other systems of serious infection and blood system diseases;(4)Severe liver and kidney failure, hemodialysis patient;(5)Nearly three weeks used thrombolysis and anticoagulation drugs. The medical history of age, gender, smoke, hypertension, diabetes, non-HDL-C, FIB were recorded. According to the image of coronary angiography integration, the SYNTAX score, the bifurcation lesion score(BL-score), and bifurcation lesions integral ratio(BL-ratio), namely BL-ratio=(BL-score/SYNTAX score)×100% was calculated.SPSS 19.0 software package was used for statistical analyses. To study of relationship between non-HDL-C, FIB and coronary bifurcation lesions. To explore the predictive value of non-HDL-C and FIB in coronary bifurcation lesions.Result: 1.The SYNTAX score of AMI group was significantly higher than UA group(18.43±9.31 vs 16.28±9.32,P< 0.05), BL-score of AMI group was significantly higher than UA(10.97±8.26 vs 9.51±7.56,P<0.05). The level of FIB in AMI group was higher than UA group,(P<0.05).2. According to the SYNTAX score, patients were divided into three groups.Non-HDL-C in high SYNTAX score group was higher than low SYNTAX score group and intermediate SYNTAX score group, non-HDL-C in intermediate SYNTAX score group was higher than low SYNTAX score group,(P<0.05,respectively). FIB in high SYNTAX score group was higher than low SYNTAX score group(P<0.05), FIB in intermediate SYNTAX score group was higher than low SYNTAX score group.3. According to the presence or absence of coronary bifurcation lesions in patients,the patients were divided into two groups. For patients with coronary bifurcation lesions,non-HDL-C and FIB was higher than those without(non-HDL-C: 3.99±1.10mmol/L vs3.62±0.98mmol/L, P<0.05; FIB: 3.38±1.11g/L vs 2.43±0.55g/L, P<0.05).4. According to the cut-off value( 3.38mmol/L) of non-HDL-C, and the cut-off value( 3.17mmol/L) of FIB, the patients were divided into A group(low non-HDL-C and low FIB), B group( low non-HDL-C and high FIB), C group( high non-HDL-C and low FIB), D group( high non-HDL-C and high FIB). The SYNTAX score,BL-score, BL-ratio in D group was significantly higher than the other groups, there have significantly statistical difference of SYNTAX score, BL-score, BL-ratio found in four groups(P<0.05).5.non-HDL-C and SYNTAX score positive correlation(r=0.193, P<0.001),non-HDL-C and BL-score positive correlation(r=0.221, P<0.001), non-HDL-C and BL-ratio positive correlation(r=0.177, P<0.001), FIB and SYNTAX score positive correlation(r=0.156, P<0.001), FIB and BL-score positive correlation(r=0.126,P<0.001), FIB and BL-ratio positive correlation(r=0.148, P<0.001), FIB and non-HDL-C positive correlation(r=0.626, P<0.001). Select BL-ratio as the dependent variable by multivariate linear stepwise regression analysis showed that both non-HDL-C and FIB were positively correlated BL-ratio.Conclusion: 1. The high level of non-HDL-C and FIB were not only associated with the severity of coronary artery stenosis, but also associated with the severity of coronary bifurcation lesions and high incidence of coronary bifurcation lesions.2. The detection of non-HDL-C and FIB have predictive value for coronary bifurcation lesions.