| Objective:1.To investigate the role of Activated Protein C(APC)in the pathogenesis of acute myocardial infarction(AMI)and the relationship between APC and the severity of coronary artery lesion based on coronary angiography.2.To investigate the relationship between the level of APC and the GRACE risk score in AMI patients,based on the outcome of GRACE risk score in AMI patients.Method:1.We selected 132 patients with chest pain who were admitted to the First Affiliated Hospital of Soochow University from 2013 to 2014.All patients underwent coronary angiography after admission and the diameter of the coronary artery was used to determine the degree of coronary artery stenosis.70 patients were diagnosed as AMI AMI as coronary angiography vascular stenosis were more than 50%;select the same period of 62 hospitalized as a control group,coronary angiography showed vascular stenosis were below 50%.2.All patients were followed up for coronary angiography.The degree of coronary artery stenosis was determined using the diameter method.The Gensini integral system was used to score points,divided into low group(<20 points),medium group(20-40 points)and high group(> 40 points);AMI patients were divided into single,double and three groups according to coronary angiography.The risk score of GRACE was calculated according to the difference of GRACE risk score.According to the difference of GRACE risk score,the patients were divided into three groups:low risk(<109 points),intermediate risk(109-140 points)and high risk(> 140 points).3.All patients were sacrificed immediately in the emergency center,and the level of APC was measured by enzyme-linked immunosorbent assay.4.Statistic software was used to analyze the changes of plasma APC in different groups,and the correlation between APC and Gensini score and GRACE risk score wasalso analyzed.Result:1.The level of plasma APC in AMI group(7.18±0.88)ng/ml was lower than that in control group(7.75±1.76)ng/ml,which was statistically significant(P<0.05).2.The plasma APC levels in Gensini low,medium and high group were(7.73 ±1.58),(7.37±0.69)and(6.49±0.48)ng/ml,respectively.There were significant differences among the three groups As Gensini scores increased(P<0.05);plasma APC levels were negatively correlated with Gensini scores(r=-0.440,P=0.00).3.The plasma levels of APC in single-vessel disease group,double-vessel disease group and triple-vessel disease group were(7.05±0.69),(7.51±1.23)and(7.17±0.86)ng/ml in AMI patients No difference was found between the two groups(P>0.05).4.The plasma levels of APC in GRACE low risk group,moderate risk group and high risk group were(7.53±1.08),(7.04±0.82)and(6.9±0.48)ng/ml.The difference between groups was statistically significant(P<0.05).The level of APC was negatively correlated with the increase of GRACE risk score(r=-0.257,P=0.032).Conclusion:1.APC levels decreased significantly in patients with AMI,and APC levels decreased with the severity of coronary lesions,suggesting that APC participate in the process of AMI development,APC level differences may be related to coronary artery disease,Low levels of APC have some influence on the development of coronary artery disease.2.APC levels were significantly lower in the high-risk group of GRACE,indirect response to the risk of AMI patients,APC can assist GRACE score risk stratification of AMI patients,for different risk levels of AMI patients choose the correct treatment strategy has some reference value. |
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