Correlation Analysis Of CD4~+,CD8~+,CD4~+/CD8~+ In Peripheral Blood With Coronary Heart Disease And Its Risk Factors

Objective:In this paper,we focused on the relationship between T lymphocyte subsets and the severity of coronary artery stenosis,syntax score and risk factors of coronary artery heart disease(CAD)by measuring the levels of CD4~+,CD8~+T lymphocytes and the ratio of CD4~+/CD8~+in peripheral blood of patients with CAD.Methods:A total of 484 patients who were treated in the department of cardiology during September 2018 to March 2020 in Yanbian University Hospital were divided into one of the control or coronary heart disease(CAD)group.According to the characteristics of the CAD patents,all the CAD patients then divided into four subgroups:stable angina pectoris(SAP)group,unstable angina pectoris(UAP)group,acute ST segment elevation myocardial infarction(STEMI)group and non ST segment elevation myocardial infarction(NSTEMI)group.All patients signed informed consent before entering the study.And all the CAD patients received a coronary angiography and had a syntax score.The levels of CD4~+,CD8~+T lymphocytes and the ratio of CD4~+/CD8~+in peripheral blood were measured by flow cytometry.Furthermore,A series of indexes of patients in control and CAD group were collected,including general information,creatinine,Total cholesterol,triglyceride,high density lipoprotein cholesterol,low density lipoprotein cholesterol,glycosylated hemoglobin and high sensitivity C-reactive protein et al.Results:1.Comparison of clinical data of patients in each group(1)The basic information of all patients,such as age,gender composition and weight,was not comparable between the control and CAD group,but the patients had a higher incidence rate of hypertension and diabetes,and longer smoking history in the CAD group;Further analysis showed that the hs-CRP,Hb A1c levels of the CAD patients were higher than that of the controls(p<0.01).2.Comparison of CD4+,CD8+,CD4+/CD8+in each group(2)The results of flow cytometry showed that the CD8~+T lymphocytes level was significantly lower in the CAD group than that of the control group.In the subgroups,the CD4~+T lymphocytes level and CD4~+/CD8~+T lymphocytes ratio in STEMI group were significantly higher than those in SAP group and UAP group(p<0.05);Also,the CD4~+T lymphocytes level,CD4~+/CD8~+T lymphocytes ratio in UAP group were higher than those in SAP group(p<0.05);Conversely the level of CD8~+T lymphocytes in NSTEMI group and STEMI group were substantially lower than of the SAP group(p<0.05)and compared to the control group,the CD8~+T lymphocytes level in UAP,NSTEMI and STEMI group were higher than those in the control group(p<0.05).3.Comparison of Syntax scores in each group(3)As expected,the syntax score of CAD group was significantly higher than that of control group(p<0.001).The Syntax score of the STEMI group was higher than that of the control and SAP group(p<0.05),the Syntax score of the NSTEMI group was higher than that of the control and SAP group(p<0.05),and the Syntax score of the UAP group was higher than that of the control and SAP group(p<0.05).4.Correlation analysis of Syntax score and immune indexes in each group(4)The CD4~+T lymphocytes level and CD4~+/CD8~+T lymphocytes ratio were positively correlated with syntax score(r=0.384,p<0.05;r=0.303,p<0.05,respectively).However,the CD8~+T lymphocytes was of opposite condition(r=-0.34,p<0.05).5.Correlation analysis between various factors and CAD(5)There was a positive correlation between CAD and gender,smoking history,hypertension,diabetes,CD4~+/CD8~+,SYNTAX score,CR,TG,hs-CRP and Hb A1c,and a negative correlation with CD8~+.6.Logistc regression analysis of various factors in CAD patients(6)Logistic regression showed that smoking history,hypertension,Hb A1c,CD4~+/CD8~+had a significant positive effect on CAD(P<0.05).However,gender(male),age,BMI,diabetes,CR,TC,HDL-C,LDL-C,TG,hs-CRP,CD4~+,CD8~+did not affect CAD(p>0.05).7.Diagnostic value of CD4~+/CD8~+ratio in circulating blood in predicting the degree of coronary artery stenosis(7)ROC curve was used to analyze the predictive diagnostic value of CD4~+/CD8~+ratio.According to the severity of the disease,the patients were divided into two groups according to the syntax score.The patients with syntax score<23 were divided into mild stenosis group and those with syntax score≥23 were divided into moderate/severe stenosis group.The optimal cut-off value of CD4~+/CD8~+ratio was1.90.The best cut-off point for predicting the degree of coronary artery stenosis is0.552,and the sensitivity was 0.587(p<0.001).Conclusion:CAD patients showed an increase in CD4~+T lymphocytes level and CD4~+/CD8~+T cells ratio,and decreased CD8~+T lymphocytes levels.And the smoking,hypertension,HBA1C,CD4~+/CD8~+ratio were independent risk factors for CAD.There was a positive correlation between syntax score and CD4~+T lymphocytes level,but a negative correlation between syntax score and CD8~+T lymphocytes level.The ratio of CD4~+/CD8~+T lymphocytes could be a new biomarker for predicting the degree of coronary stenosis.