Relationship Between Endorhelial Cell Specific Molecule-1,Neutrophil Elastase And Metalloproteinases-9 With Coronary Artery Ectasia

Objective To investigate the relationship between serum endothelial cell specific molecule-1(ESM-1),neutrophil Elastase(NE),Matrix metalloproteinase-9(MMP-9)and coronary artery ectasia(CAE).Methods From January 2018 to July 2019,252 patients who were admitted to the first ward of the Department of Cardiology of Inner Mongolia People’s Hospital for coronary angiography or CTA examination were selected.They were divided into 47patients(coronary artery dilatation group),125 patients(coronary heart disease group)and 80 normal patients(normal group).Collecting the patients’ Clinical data including gender,age,smoking history,previous history(hypertension,diabetes history),clinical diagnosis,admission ECG,hypersensitive C-reactive protein,urea,creatinine,blood uric acid,triglyceride,total cholesterol,HDL-C,LDL-C,NT pro BNP,c Tn T,etc.were collected.The serum levels of ESM-1,NE and MMP-9 were determined.The factors influencing the severity of coronary artery dilatation were analyzed by logistic regression analysis.Receiver Operating Characteristic(ROC)curve was used to evaluate the predictive value of serum ESM-1,NE,MMP-9 for coronary artery dilatation.Results 1.Forty-seven patients with coronary artery dilatation involved 55 coronary artery dilatation lesions,of which 8 were saccular expansion,37 were fusiform expansion,and 10 were diffuse expansion.It occurred in 15 left anterior descending arteries,12 left circumflex arteries,and 28 right coronary arteries.Coronary artery stenosis was associated with 23 vessels,and coronary dilatation of 16 vessels was associated with stenosis.2.The level of serum ESM-1 increased gradually in the normal group,coronary artery dilatation group and coronary heart disease group(174.61±25.23)ng/ml vs(211.79±22.67)ng/ml vs(214.13±25.13)ng/ml respectively;the level of serum NE increased gradually in the normal group,coronary artery dilatation group and coronary heart disease group(38.84±5.69)ng/ml vs(41.99±9.53)ng/ml vs(46.57±5.19)ng/ml respectively;The level of serum MMP-9 increased gradually in normal group,coronary heart disease group and coronary artery dilatation group(569.72±110.66)ng / ml vs(717.57±95.78)ng / ml vs(728.51±97.47)ng/ml respectively.3.The levels of ESM-1,NE,and MMP-9 in the coronary artery dilatation and coronary heart disease group were higher than those in the normal control group,(p=0.000);There was no difference in the levels of ESM-1 and MMP-9in the coronary artery dilation and coronary heart disease group,p> 0.05;The level of NE in the coronary heart disease group was higher than that in the coronary artery dilatation group,p<0.01.4.The levels of ESM-1 and MMP-9 in patients with coronary artery dilatation were significantly higher than those in the normal control group,p= 0.000;The level of NE in patients with coronary artery dilatation was higher than those in the normal control group,p=0.000.5.The levels of ESM-1 and MMP-9in patients with coronary heart disease were significantly higher than those in the normal control group,p=0.000;The level of NE in patients with coronary artery dilatation was higher than those in the normal control group,p=0.000.6.The AUC of serum ESM-1,NE and MMP-9 in predicting coronary artery dilatation was 0.624,0.534 and 0.661,respectively,P was 0.005,0.450 and 0.000.The area under ROC curve of serum ESM-1 and MMP-9 was 0.624(0.549-0.699)and 0.661(0.584-0.738),respectively.The sensitivity and specificity of ESM-1 in diagnosing coronary artery dilatation were 85.2% and 38.4%,72.2% and 56.1%,respectively.Conclusion 1.Coronary artery dilatation is more common in right coronary artery.2.Local hemodynamic changes caused by coronary stenosis may be the cause of dilated lesions.3.There were no differences in risk factors,endothelial factors and inflammatory factors in adult patients with coronary artery dilatation and coronary heart disease,and there may be a common pathogenesis.4.The higher the level of serum ESM-1,the more serious of the CAE,the higher the level of MMP-9,the more serious of the CAE.Serum ESM-1,MMP-9 have a higher predictive value for CAE,which can be considered as independent risk factors of CAE.