Relationship Between Serum Lipoprotein-associated Phospholipase A2 Level And Clinical Phenotype Of Coronary Heart Disease

Aim:To investigate the relationship between the blood level of lp-pla2 and the clinical phenotype of coronary heart disease.Method: From April 2019 to December 2019,154 patients in the department of cardiovascular medicine of yongzhou central hospital were randomly selected.According to their clinical symptoms,biochemical examination results and improved coronary angiography,63 patients in the acute coronary syndrome group(group A,)and 91 patients in the stable angina group(group B)were divided into the acute coronary syndrome group(group A,)and the stable angina group(group B)according to the guidelines.At the same time,104 healthy physical examinees in yongzhou central hospital were selected as the control group(group C).Improve ecg,troponin,triglyceride,total cholesterol,LDL,HDL,creatinine and other indicators;The LP-PLA2 level was determined by rate scattering turbidimetry.SPSS statistical software was used to analyze and compare the LP-PLA2 levels of patients in each group.Mean ± standard deviation((?)±s)was used to represent the measurement data conforming to normal distribution,and the count data was expressed as percentage(%).The chi-square test was used to compare the differences between groups in the univariate analysis.T test was used for comparison between the two groups,variance analysis was used to compare the differences between groups of normal distribution measurement data,Pearson correlation coefficient was used to analyze the correlation between the two variables,and ROC curve was used to analyze the predictive value of the clinical phenotype of coronary heart disease assisted by LP-PLA2.P<0.05 was considered statistically significant.Results:1.A total of 258 patients were included in this study,including 63 patients in group A,with an average age of 61.4±11.2 years,35 males(55.6%),28 females(44.4%),17 smokers(27.0%),and 38 patients(60.32%)with abnormal serum lipid.In group B,there were 91 patients,with an average age of 63.3±9.0 years,48 males(52.7%),43 females(47.3%),21 smokers(23.1%),and 55 patients(60.44%)with abnormal serum lipid.In group C,there were 104 patients,with an average age of 61.3±6.0 years,48 males(46.2%),56 females(53.8%),10 smokers(9.6%),and 58 patients(55.77%)with abnormal serum lipid.2.Group A included 25 patients with hypertension(39.7%),8 patients with diabetes(12.7%),and 6 patients with both hypertension and diabetes(9.5%).In group B,there were 38 patients(41.8%)with hypertension,20 patients(22.0%)with diabetes,and 7 patients(7.7%)with both hypertension and diabetes.In combination with hypertension,27(26.0%),4(3.8%)with diabetes,and 1(0.9%)with both hypertension and diabetes.3.The LP-PLA2 level was 203.44±23.48 ng/ml in group A,144.40±21.82ng/ml in group B,and 107.83±24.19 ng/ml in group C.Pairwise comparison showed that the difference between any two groups was statistically significant(P< 0.05).The level of LP-PLA2 in patients with coronary heart disease combined with hypertension was higher than that in patients without hypertension,the difference was statistically significant(P<0.05).4.The experimental data obtained by ROC curve analysis in this study showed that lp-pla2 could be used to judge coronary heart disease and its clinical phenotype,and the area under ROC curve was 0.932(95%CI: 0.901-0.962,P<0.05)when LP-PLA2 was used to assist in the diagnosis of coronary heart disease.When the cut-off value of LP-PLA2 was 131.85,it was most effective in the determination of coronary heart disease,with a sensitivity of 87.7% and specificity of 87.5%.The area under the ROC curve was 0.984(95%CI: 0.971-0.998,P<0.05)when it was used to assist in the diagnosis of ACS.When the truncated value of LP-PLA2 was 176.05,its performance was the highest,the sensitivity was 92.1%,and the specificity was 96.7%.Conclusion:1.The level of blood LP-PLA2 is related to the clinical phenotype of coronary heart disease,and the level of lp-pla2 in patients with acute coronary syndrome is higher than that in patients with stable angina.2.LP-PLA2 can be used to judge coronary heart disease and its clinical phenotype,and the cut-off value is 131.85 when it is used to assist in the diagnosis of coronary heart disease.When the truncation value of lp-pla2 is 176.05,its performance of judging ACS is the highest.